Team Access Form

HEARTLAND MULTIPLE LISTING SERVICE, INC.
Phone: 913.661.1600 Fax: 913.661.1618
One Hallbrook Place, 11150 Overbrook Rd., Ste. 125, Leawood, KS 66211

Team Member Requesting Access 1(Required)

First Last

Matrix User ID 1(Required)

Team Member Requesting Access 2

First Last

Matrix User ID 2

Team Member Requesting Access 3

First Last

Matrix User ID 3

Team Member Requesting Access 4

First Last

Matrix User ID 4

Team Member Requesting Access 5

First Last

Matrix User ID 5

I hereby authorize the above Heartland MLS Subscribers to act on behalf of me in the Matrix system. The team members listed will have the same capabilities as I do including listing input and modification if applicable. Each team member must be a current Subscriber. I understand that it is my responsibility to update this form when
necessary.

If a Separate (branded) team is granting access, please provide the Separate Team’s Name and the corresponding ID

Subscriber Granting Access Name(Required)

First Last

Subscriber Granting Access Matrix User ID(Required)

Subscriber Granting Access Signature (or responsible member)(Required)

Date(Required)

Office Name(Required)

Office Code(Required)