Real Estate Transaction Verification Form

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REV. 8/05
REAL ESTATE TRANSACTION VERIFICATION FORM
RSA 331-A:10, II (g) requires all broker applicants to submit evidence acceptable to the Commission of at least 6 separate
real estate transactions in which the applicant was actively involved and was compensated for.
The signature of the applicant’s principal broker will be required, attesting that all information regarding each transaction
is accurate and complete. PLEASE NOTE: If you were employed by or under contract with more than one principal
broker for the transactions listed, please supply a separate principal broker verification section for each broker along with
the appropriate real estate transactions.
Broker Applicant’s Name:________________________________________________
Date of Transaction:______________________
Location of Property:____________________________________________________
Type of Transaction:
Commercial
Residential
Land
Multi-Family
Other
(Explain)_____________________ (Please Note: Rentals for Residential and Multi-Family Transactions are
not acceptable, except for Property Managers who deal exclusively in rentals of residential properties.)
Applicant’s Agency/Non-Agency Relationship:_______________________________________________
Were There Other Licensees Involved? _____ Yes _____No. If Yes, in What Capacity?__________________________
Description and Significance of Applicant’s Involvement: (Significance shall be interpreted to mean that the licensee’s
involvement was equal to or greater than 50% of the overall brokerage involvement)______________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Date of Transaction:______________________
Location of Property:___________________________________________________
Type of Transaction:
Commercial
Residential
Land
Multi-Family
Other
(Explain)_____________________ (Please Note: Rentals for Residential and Multi-Family Transactions are
not acceptable, except for Property Managers who deal exclusively in rentals of residential properties.)
Applicant’s Agency/Non-Agency Relationship:_______________________________________________
Were There Other Licensees Involved? _____ Yes _____No. If Yes, in What Capacity?__________________________
Description and Significance of Applicant’s Involvement: (Significance shall be interpreted to mean that the licensee’s
involvement was equal to or greater than 50% of the overall brokerage involvement)______________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
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