Limited Function Referral Office (LFRO) Certification Form
  

In accordance with Article X, Section 2 of the association’s Bylaws, this will certify that the undersigned Designated REALTOR® has a direct or indirect ownership interest in an entity engaged exclusively in soliciting and/or referring clients and customers to the REALTOR® for consideration on a substantially exclusive basis.

This will also certify that all of the licensees affiliated with that entity (list provided below) are solely engaged in referring clients and customers and are not engaged in listing, selling, leasing, managing, counseling or appraising real property.

 
First Name*
 
 
Last Name*
 
 
 
Email Address*
 
 
Office Phone
 
 
Broker Office Name*
 
 
Office Address*
 
 
Please include agent’s name and license number: 
1.
 
 
 
 
2.
 
 
 
 
3.
 
 
 
 
4.
 
 
 
 
5.
 
 
 
 
 
 
 
If your agent names exceed this list, please upload the remaining names in a document
 
 
 
 
 
 
 
I agree to the terms listed above*
 
 
 
 
 
 
 
Signature (Enter Full Name)*