Broker'S Application Form

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NEW
RENEWAL
BROKER’S APPLICATION FORM
APPLICATION
RECEIVED BY:
Revised Form Version Date 8.18.16
DATE RECEIVED:
C O M P A N Y P R O F I L E
Name of Realty
REALTY
Individual Broker
Firm or Broker
FIRM
Residential
Company
Tax
Address
Identification No.
Personal
Authorized Representative (
PRC Registration
Validity
for Realty Firm )
#:
Dates:
HLURB
Date
Registration #:
Issued:
Place of Birth :
Date of Birth:
/
/
Citizenship:
Age :
Gender:
Civil Status:
Landline No :
Cellphone No :
EMAIL
FACEBOOK :
ADD/WEBSITE:
T R A C K
R E C O R D
I N
R E A L
E S T A T E
NO. OF YRS IN REAL ESTATE
NO. OF YEARS THE REALTY FIRM HAS BEEN IN OPERATION:
ACCREDITATION WITH OTHER DEVELOPER TOTAL NO. OF MANAGERS:
TOTAL NO. OF SALES PERSONS:
NO. OF
INCLUSIVE DATE
YEARS OF
COMPANY / LOCATION OR DEVELOPER
PROJECT
UNITS
TOTAL SALES VALUE
FROM
TO
EXPERIENCE
SOLD
*provide certification or proof of sales
A C K N O W L E D G E M E N T
I hereby commit to abide by, and/or to the following basis of my accreditation:
_______________________________
◦ Abide by the Rules and Regulations and Code of Ethics governing HT Land Inc.'s accredited agents.
SIGNATURE OVER PRINTED NAME
(1x1 ID PICTURE)
◦ Attain the required sales production set by HT Land Inc., management
◦ Obtain licenses and permits as required by Law and HT Land Inc., management
_______________________________
DATE
I understand that failure to attain any of the aforementioned conditions and any false statements/
information herein may be grounds for HT Land Inc., to disapprove my application for accreditation.
F O R
HT LAND U S E
O N L Y
REQUIREMENTS
STATUS OF APPLICATION
SALES RECRUITMENT – ACCREDITATION
BROKERS ORIENTATION PROGRAM
DATE PROCESSED:
Properly filled up Broker's Application Form
APPROVED
___________________TRAINING DATE: _______________
PRC License ( Photocopy)
DISAPPROVED
PROCESSED BY:
___________________TRAINING VENUE: ______________
HLURB Registration Certificate (Photocopy )
CONDITIONAL
APPROVED BY:
___________________TRAINOR: _____________________
DTI Certificate of Business Name ( for single proprietor
ACCREDITATION DATE:
___________________BSM: ____________________
and partnership ) SEC ( for Corporation)
TIN Card ( Photocopy) OR any proof showing the TIN
Brokers' 1pc 1x1 ID pic ( white background)
Brokers' 1pc 2x2 ID pic ( white background)
Official Receipt- is not pre requisite but required for the
release of comm. or any other forms of payment.

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