Name: ____________________________________
Address:___________________________________
City:___________________ State:_____ Zip:_________________
Home phone:( ) ____________Work phone:( ) _____________Cell phone:( )_______________
Email:_________________________________Fax number:( )_______________________________
| I am interested in: |
| □ selling a home/property |
□ buying a home/property |
□ both |
Preferred local Alfa Realty agent or preferred local agent if outside Montgomery, Elmore or Autauga Counties:
Name: ______________________________________________
Company: _____________________________________________
Notice and Disclaimer
This cash incentive program may be discontinued or modified at any time without notice. If the member or a referring real estate company, agent or broker fails to comply with Alfa Realty’s requirements or with applicable real estate laws governing cash incentives in real estate transactions, it may render the Alabama Farmers Federation member(s) ineligible to receive the cash incentive.
Terms and Conditions
By completing this application and submitting it for enrollment, you agree to all of the terms and conditions of this incentive program as it currently exists or is modified. You further understand and agree that, for whatever reason, if the cash incentive is not applied at closing, then neither Alfa Realty, Inc., its agents nor employees, or any referring agent, broker or company or its employees, can pay a cash incentive after the closing has occurred, as it is prohibited by law. You further agree to release, indemnify and hold harmless the Alabama Farmers Federation, Alfa Realty, Inc., and any referring agent, broker or company, and each of their parents, affiliates, subsidiaries, officers, directors, shareholders and employees of each, from and against all loss, cost, expense or damage of any kind whatsoever arising directly or indirectly from this incentive program
OFFICE USE ONLY:
Member Verification:
Member Name: _____________________________________________________
Member Number: ____________________________________________________
Verified by: _________________________________ Date Verified:____________
Verified Copy to Agent:____________________________ Date:______________ |
 |
Mail to:
Alfa Realty | 8191 Seaton Place | Montgomery, AL 36116
Fax to: 1-800-810-0573 |
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