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Personal Information

First Name

Last Name

Home Address

Home City

Home State

Home Zip Code

Cell Number

Real Estate License

Owner/Broker

License Type

License Number

Complaints Pending

State of Issue

License Expiration Date

Errors and Omissions Insurance - FOR ALL

All members, applicants, affiliates, are REQUIRED to have E&O coverage whether they own the company or not.

Owns company

Yes No

Insurance Company

Policy Number

Expiration Date

Claims Pending

Yes No

Agent Name

Agent Phone

Minimum Coverage 500K/1 Million

Yes No

Reference Information

List REO (Real Estate Owned) Institutions or corporate clients for whom you have LISTED bank-owned (REO) properties for. Please enter Name, Company, Phone and email for each reference you list. A minimum of THREE ACTIVE references from THREE different REO institutions is required to complete the application. You may provide more references in the additional fields provided. A reference request will be sent to those you list below.

Reference 1

Person's Name

Reference Company

Reference Phone

Reference Email

Reference 2

Person's Name

Reference Company

Reference Phone

Reference Email

Reference 3

Person's Name

Reference Company

Reference Phone

Reference Email

Reference 4

Person's Name

Reference Company

Reference Phone

Reference Email

Reference 5

Person's Name

Reference Company

Reference Phone

Reference Email

Realtor Board or MLS Affiliation or Bar Association Information

*Realtor Board/MLS Name or Bar Association:

*Contact Name:

*Contact Phone:

Realtor Board/MLS Name or Bar Association:

Contact Name:

Contact Phone:

Realtor Board/MLS Name or Bar Association:

Contact Name:

Contact Phone:

NRBA Members: The Gold Standard for REO, Short Sales, and Institutional Property Management

Personal Information

Company Information

Real Estate License

Errors and Omissions Insurance - FOR ALL

Reference Information

Reference 1

Reference 2

Reference 3

Reference 4

Reference 5

Realtor Board or MLS Affiliation or Bar Association Information

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