If you are a licensed realtor and you would like to provide BPO, Inspection, or REO services for ELAM REO Services, please complete and submit this Broker Registration form. When we have a need for additional real estate professionals in your service area, we will send an approval notification to your E-mail address, which will include your Login/Password information. Upon completion of your first order from ELAM, we will require you to submit a copy of your
W-9. Thank you!

***NOTE: PLEASE MAKE SURE YOU FILL OUT THE ENTIRE BROKER REGISTRATION FORM COMPLETELY. DO NOT LEAVE ANY BLANKS. BE SURE THAT ALL FIELDS IN THE REFERENCES SECTION ARE COMPLETELY FILLED IN OR AN ERROR WILL OCCUR.***

Your Information: * First Name: * Last Name: * Email Address: * Re-Type Email Address: * Office Phone#:  ext:   Mobile Phone#:   Pager#: * Fax#: * Real Estate License #1: * License #1 Expiration Date:  i.e. mm/dd/yyyy   Real Estate License #2:  (optional)   License #2 Expiration Date:  i.e. mm/dd/yyyy Company Information: * Company Name: * Address:   Address 2: * City: * State: Please Select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming * Zip Code: Billing Information: * Make checks payable to: * Address:   Address 2: * City: * State: Please Select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming * Zip Code:

Please list your preferred zip code service areas (up to 8):   Town Name Zip Code   Please be sure to provide BOTH a Town Name and Zip Code for each row you enter. Assignments are frequently assigned by zip code coverage. Please list as many zip codes as you will cover. Prior Experience * How many year(s) have you been a licensed realtor? Year(s) * Do you have experience with online processing of broker price opinions? Yes      No * Do you have experience with uploading photos online? Yes      No * Do you have experience with completing drive-by broker price opinions? Yes      No * Do you have experience with completing interior broker price opinions? Yes      No * How many years of experience have you had with listing real estate owned (REO) properties? Year(s) * Do you have experience with completing broker price opinions for COMMERCIAL properties? Yes      No References Please list 2 financial institution contacts / references that you have worked with in listing REO properties or completing BPO's:   * Reference 1 * Reference 2 * Contact Name: * Company: * Phone#: * Email Address:

We Appreciate Your Interest in ELAM REO Services!