M&AMI Transaction Submittal Form

This form is used for M&AMI Certification and/or recertification credits for completed business transactions. Please complete this form for each transaction and attach the required documentation.

Applicant should provide the follow documents as proof of the transaction and as proof that the intermediary firm was the intermediary of record.

1. SIGNED Closing Statements demonstrating the total sale, asset content of real estate (if any) and
intermediary commissions paid at closing. If a closing statement is not available due to a private
equity closing, or “self-handled” company accretion, an affidavit from the attorney, accountant, PEG
or your client ON THEIR RESPECTIVE LETTERHEAD should be provided and signed by a principal or the
signed letter should describe the deal and verify its’ closing and the primary intermediary.

2. In addition to the above, if the applicant is a member of a firm that operates as a “team” or a “subcontractor” to the firm, the principal of the firm (or participating partner(s)) should provide a notarized affidavit that verifies that the applicant was the “Primary Intermediary” and managed the
primary responsibilities of the transaction.

I attest to the above and attached information to be factual and true.

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