Real Estate Professional Information Submission Form

Name:

Company (if applicable):

Real Estate Agent License #:

License Expiration Date

mm/dd/yyyy

Merchants Registration

(Registro de Comerciante)

mm/dd/yyyy

E-mail:

Telephone Number:

Phone

Regions to offer services (Please choose all that apply):

Required Documents [Upload Fields]:

1) Copy of Real Estate Agents License*

2) Good Standing Certification [Not Required to Submit]

3) Commercial Registry Certification (Certificación Registro de Comerciante) (If applicable)

Drop your files here

By clicking “Submit” you acknowledge you are a licensed real estate professional who will be under consideration to be listed for availability to R3 Relocation applicants for the regions indicated above.

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