COMMUNITY DEVELOPMENT DISTRICT
REALTOR AUTHORIZATION FORM
Homeowner:_____________________________________________
Property Address:_______________________________ Contact Phone Number:________________
Property Status:
For Sale
For Rent
Listing term FROM:_____________________________TO
:________________________(
)
MUST HAVE A DATE
st
If no term is filled in this document will automatically expire on December 31
Real Estate Agency:______________________________Agency Phone Number:_________________
Agent:_________________________________________ Agent Contact Phone #:_________________
Agent:_________________________________________ Agent Contact Phone #:_________________
Level of Authority Granted to Agent (
):
CHECK ONE ONLY
If more than one are checked or none is checked then NO call in Authority will be authorized.
Authorized to call in Guests ONLY.
Authorized to call in Services ONLY.
Authorized to call in Other Realtors ONLY
Authorized to call in Guests and Services.
Authorized to call in Guests, Services, and Realtors
NO CALL IN AUTHORITY
Homeowner Signature:_______________________________________ DATE:___________________
This form must be signed and dated by the homeowner to be valid.
Electronic Signatures will not be accepted
Return to any PMCDD Gatehouse or FAX 239-592-9021
This form supersedes all other forms prior to 05/2015