Submission Form for Possible

Top Ten Provincial Status

** Please PRINT legibly

Name of Nominee/

Lead Agent:

This candidate will be in the “Individual” or “Team” category. (See definitions below.) Note – if candidate is in the Team category, please list the name(s) of the member(s) who form the team:

DEFINITION OF INDIVIDUAL:

An “Individual” is a salesperson who does not have any Licensed Assistant(s), nordoes he/she receive credit for any commissions generated by another salesperson.

DEFINITION OF TEAM:

A “Team” is any group of two or more licensed salespeople that combine their income in any way for any purpose, including awards.

“Team” also includes any group of two or more licensed salespeople that work together and/or market/promote themselves together, regardless of income sharing. This definition applies even if the team members combined their commission incomes and/or worked together and/or marketed themselves together for a shorter length of time than a fullqualifying year (i.e. a week, a month, a quarter, etc.), within the qualifying year.

(For clarity on Team or Individual categories, please consult the Team Award Guidelines)

$ Gross Closed and Collected Earnings from Dec 1, 2012 to Nov 29, 2013 [since the 30th is a Saturday] (net of GST, QST, before office splits)

Company Name:

Office Address

(out of which Nominee works): Full Address

CityProvincePostal Code

Toll Free: Email

We, the undersigned are submitting the above name as a possible candidate for the 2013 Provincial Top Ten Award. We hereby certify that the submitted information is correct. We also understand that submission of this form does NOT guarantee that the Realtor will qualify for this award.

1. Broker Certification:

Print NameSignature

Date:

I have attached the required agent production report as backup

Fax to the attention of Nelia Luis at (416) 510-5856 by no later than Thursday December 12, 2013. Late or incomplete submissions will not be accepted.