Office Transfer Request

Office Transfer Form

"*" indicates required fields

It is the obligation of the REALTOR/AGENT to complete this form in it’s entirety. Credit card information is required for the office transfer to be completed. Each office transfer is $25. Please confirm Office MLS Bill code with your office or broker prior to completing this form. Any information that is not filled out correctly or missing fields will result in delayed processing time.

Subscriber First Name*

Agent or Appraiser

Subscriber Last Name*

Effective Date*
MM slash DD slash YYYY

Nickname

Personal contact number that will appear in HMLS and on Listings & Reports:*

Mobile Phone

Office Phone

Mobile Phone*

Office Phone*

Website

Email*

Transfer From Office Name*

Transfer From (Office Code/ID)*

Transfer To Office Name*

Transfer To (Office Code/ID)*

If you do not know this, please see your Broker.

Debit/Credit Card:*
*Your transfer fee ($25) must be paid up front, at time of processing*

Exp. Month (E.g. 05)*

Exp. Year (E.g. 2024)*

Hidden

Expiration Date:
MM slash DD slash YYYY

For two digit date just use first day of month. i.e. 11/2024 would be 11/1/2024.

CID # / Security Code – (Usually on the back of your debit or credit card.)*

3 or 4 digit code

Name on Card*

Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Signature

I understand my card will be processed $25.00*
Yes
I understand my card will be processed $25.00 for this Office Transfer.

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