Personal Assistant Access Form

PERSONAL ASSISTANT ACCESS FORM

"*" indicates required fields

Step 1 of 2

Is this a replacement Personal Assistant (or are you reusing and existing ID that was assigned to another personal assistant)?*

Yes

You will be charged an MLS Technology fee if you select NO here. There are no refunds if a new personal assistant ID is generated.

User ID being replaced:*

Name of User being replaced:*

MLS ID*

PA ID?

HEARTLAND MULTIPLE LISTING SERVICE, INC.
One Hallbrook Place, 11150 Overbrook Rd., Ste. 100, Leawood, KS 66211
Phone: 913-661-1600 Email: membership@kcrar.com

This form must be submitted to the Kansas City Regional Association of REALTORS® and all fees must be paid prior to activation of your Heartland MLS access. It is the obligation of the Participant (Designated REALTOR® Member) to have this form completed in full and submitted for everyone who will become a personal assistant to any Subscriber of the Heartland MLS.

Are you located in Southeast Kansas?*

Personal Assistant First Name*

Personal Assistant Last Name*

Effective Date*

Contact Phone*

Email*

Main Office Phone*

Unlicensed Assistant:*

Yes

License #: MO

License #: KS

Company holding license**:*

**Personal assistants whose license is NOT with a REFERRAL ONLY Company will need to join KCRAR as a REALTOR® member for the Broker to avoid receiving an assessment for dues.
REALTOR members are not allowed to have HMLS access as PA.

The Personal Assistant, Sponsoring Subscriber, and Participant hereby request access to Heartland Multiple Listing Service, Inc., for the individual shown above and accept all responsibility for their actions as it relates to their use of the MLS system. All parties agree that the Personal Assistant will use their access for the sole purpose of administrative duties that do not require a real estate license, including but not limited to holding open houses, providing property information to buyers or sellers, showing property, and discussing contracts.

The sponsoring Subscriber understands that they will be billed for all fees for the personal assistant

Sponsoring Subscriber:*

(Agent or Appraiser)

Subscriber User ID:*

Subscriber Signature*

Date*

Office Name*

Office MLS Code*

NOTE: Payment for $25.00 Initial Technology Fee and quarterly HMLS PA access fees ($60.00 per quarter) must be included with this Access Form in order to process.

Debit/Credit Card:*

Expiration Month (Eg: 01)*

Expiration Year (Eg: 2024)*

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

Credit Card Billing Address*

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

Payment Signature*

Date*