Company/Broker Application

APPLICATION FOR COMPANY/BROKER MEMBERSHIP

To the Northeast Atlanta Metro Association of REALTORS®, I hereby apply for REALTOR® Membership in the above named Board. In the event of my election, I agree to abide by the Code of Ethics of the National Association of REALTORS®, which includes the duty to arbitrate, and the Constitution, Bylaws and Rules and Regulations of the above named Board, the State Association and the National Association, and if required, I further agree to satisfactorily complete a reasonable and non-discriminatory written examination on such Code, Constitutions, Bylaws and Rules and Regulations. I understand membership brings certain privileges and obligations that require compliance. Membership is final only upon approval by the Board of Directors and may be revoked should completion of requirements, such as orientation, not be completed within timeframe established in the association’s bylaws. I understand that I will be required to complete periodic Code of Ethics training as specified in the association’s bylaws as a continued condition of membership. There is a one-time application fee of $25 for all new companies and brokers.

NOTE: Applicant acknowledges that if accepted as a member and he/she subsequently resigns from the Board or otherwise causes membership to terminate with an ethics complaint pending, the Board of Directors may condition renewal of membership upon applicant’s certification that he/she will submit to the pending ethics proceeding and will abide by the decision of the hearing panel. If applicant resigns or otherwise causes membership to terminate, the duty to submit to arbitration continues in effect even after membership lapses or is terminated, provided the dispute arose while applicant was a REALTOR®.

* Last Name:

* First Name:

* Gender:

* Company:

Company Information:

* Please List Corporate License # and Real Estate License #:

* Number of Active Licensed Real Estate Agents with Company:

* Your Position:

Names of other Brokers/Partners/Officers of your firm:

* Company Address:

* City:

* State:

* Zip Code:

* Phone:

* Fax:

* Web Address:

* Is the Office Address your principal place of business?

Yes

If not, or if you have any branch offices, please indicate and give address:

* Residence Address:

* City:

* State:

* Zip Code:

* Phone:

* Cell Phone:

* Email Address:

Preferred Mailing:

Home

Office

Preferred Phone:

Home

Office

Cell Phone

* Date of Birth:

Foreign Language:

Specialty:

How Long With Current Real Estate Firm?

Number of Years in Real Estate Business:

Previous Real Estate Firm (if applicable):

* Are you presently a member of another Association of REALTORS^®?

Yes, I am applying for Secondary Membership	Yes, Please Transfer Membership to Primary Member
No

If yes, name of Association:

If you are now or have ever been a REALTOR^®, indicate your NAR membership (NRDS)#:

* Have you been found in violation of the Code of Ethics or other membership duties in any Association of REALTORS^® in the past three (3) years or are there any such complaints pending?

Yes, Provide details in an attachment

If yes, please provide details in an attachment

Last date (year) of completion of NAR's Code of Ethics training requirement: (If you have not taken the Ethics class/Orientation, then you agree to take the required class within 90 days of the date of this application.)

* Have you ever been refused membership in any other Association of REALTORS^®?

Yes

If yes, state the basis for each such refusal and detail the circumstances related theretoL

* Do you hold, or have you ever held, a real estate license in any other state?

Yes

If so, where:

* Have you or your firm been found in violation of state real estate licensing regulations within the last three years?

Yes

If yes, please attach document providing details.

* Have you or your firm been convicted, adjudged, or otherwise recorded as guilty by a final judgment of any court of competent jurisdiction of a felony or other crime.

Yes

If yes, please attach document with details

* Would You Like to Contribute to RPAC?

Yes

Payment: Once you receive the email with your username and password, you will have 24 hours to pay online at www.namar.org or call (770) 495-7300 to pay your dues. If payment is not received within 24 hours, your account will be marked as inactive.

CHECKS PAYABLE TO: NAMAR ($35.00 SERVICE CHARGE FOR ALL RETURNED CHECKS)

*"Contributions to RPAC are recommended and used for political purposes. The amount indicates is only a suggestion and you may give more or less of refuse to contribute without affecting your membership rights. Contribution will be split with 95% to RIAC (A fund to support issues) and 5% to RPAC, which will be further divided as described below. 70% of each RPAC contribution is used by Georgia RPAC to support State and Local Political candidates. 30% of the balance is sent to National RPAC to support Federal candidates and is charged against your limits under 2 U.S.C. 441 A: 65% of the NRRPAC contributions are used for other federal grassroots political activities. Contributions are not deductible as charitable contributions for Federal Income Tax Purposes."

The portion of dues paid that is spent to lobby the State and Federal governments is ‘NOT DEDUCTIBLE FOR INCOME TAXES” purposes. GAR has estimated that $14.59 (19.98%) is the nondeductible portion of 2012 GAR dues. NAR has estimated the nondeductible portion of its 2012 dues to be $37 (31%). The entire $35 NAR Public Awareness Campaign Assessment qualifies deductible dues. Any local dues that qualify as nondeductible lobbying expense must also be disclosed.

I hereby certify that the foregoing information furnished by me is true and correct, and I agree that failure to provide complete and accurate information as requested, or any misstatement of fact, shall be grounds for revocation of my membership if granted. I further agree that, if accepted for membership in the Board, I shall pay the fees and dues as from time to time established. NOTE: Payments to the Northeast Atlanta Metro Association of REALTORS® are not deductible as charitable contributions. Such payments may, however, be deductible as an ordinary and necessary business expense. No refunds.

By signing below I consent that the REALTOR® Associations (local, state, national) and their subsidiaries, if any (e.g., MLS, Foundation) may contact me at the specified address, telephone numbers, fax numbers, email address or other means of communication available. This consent applies to changes in contact information that may be provided by me to the Association(s) in the future. This consent recognizes that certain state and federal laws may place limits on communications that I am waiving to receive all communications as part of my membership.

* Date:

* Signature: (Please type name in field)

* Indicates Response Required