(To be assigned by Alaska Auction Company)
PRELIMINARY
BUYER’S BROKER INCENTIVE PROGRAM
BROKER REGISTRATION FORM
Anchorage Alaska
Broker Information
Property Description: .
.
Listing Company: .
BROKER/AGENT: ______________________________________________________________
COMPANY NAME: _____________________________________________________________
COMPANY ADDRESS: _________________________________________________________
CITY: ________________________ STATE: ______________ ZIP CODE: ________________
LICENSE NUMBER: ________________________ BROKER NUMBER: _________________
TAX IDENTIFICATION NUMBER: _______________________________________________
OFFICE PHONE: _____________________________ FAX: ____________________________
MESSAGE CENTER/PAGER: _____________________CELL PHONE: __________________
Client (Buyer/Bidder) Information
CLIENT: ______________________________________________________________________
ADDRESS: _____________________________________________________________________
CITY: _________________________ STATE: ______________ ZIP CODE: _______________
HOME PHONE: ____________ OFFICE PHONE: ____________CELL PHONE: ___________
Bidder Deposit:______________________________________
Bidders Starting Bid______________________________________________________
I would like to hear more about your services.
_____ Call me at these numbers about opportunities to buy or sell property.
_____ I am interested in potential investment property.
Bidders Signiture________________________________________________
Page 1 of 1 Broker Initials _________ Broker
Incentive Form