LFRO Certification

2023 Limited Function Referral Office (LFRO) Certification Form

"*" indicates required fields

In accordance with Article IX , Section B , of the association’s bylaws, this will certify that the undersigned Designated REALTOR® (or his firm) 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 and are not participants or subscribers in any Multiple Listing Service (“MLS”).

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, renting, managing, counseling, appraising, or arranging financing for real property.

Please include agent's name and license #*

The exemption for any licensee included on the certification form shall automatically be revoked upon the individual being engaged in real estate licensed activities (listing, selling, leasing, renting, managing, counseling, appraising, or arranging financing for real property) other than referrals or upon their joining an MLS, and dues for the current fiscal year shall be payable.

Name*

First Last

Date*

Name of Brokerage*

Name of LFRO Entity*

Phone*

Email*

Signature*

Please type in your full name. By doing so you certify that the information in this document is true and accurate.

Last modified: March 28, 2023 at 8:47 am | Originally published: April 15, 2021 at 11:02 am
Printed: October 6, 2024