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Organization Detail
Company/Business name
Company Type
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Unknown
LLC
Individual
LLP
Corporation
LP
Is National
Physical Address
Address 1
Address 2
City
State
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Alaska
American Samoa
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Colorado
Connecticut
Delaware
District of Columbia
Federated States Of Micronesia
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Hawaii
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Marshall Islands
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Mississippi
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New Hampshire
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Northern Mariana Islands
Ohio
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Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
Billing Address
Same as physical address
Address 1
Address 2
City
State
-- Select --
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States Of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
Contact Details
First Name
Last Name
Work Phone
Extension
Other Phone
Fax Phone
Cell Phone
Do you have text messaging capability?
Yes
No
Email
User Name
Details
You can have a brief marketing description to reach all Solidifi's clients for future REO listings
Business Type
Agent/Broker
Yes
No
Licensed/Certified Appraiser
Yes
No
License Type
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Licensed Appraiser
Certified Appraiser
Certified General Appraiser
Licensed Associate Broker
Licensed Broker
Licensed Salesperson
Licensed Broker Salesperson
FHA Certified
Yes
No
FHA License Number
Do you provide property condition Inspections?
Yes
No
Business Diversity
Solidifi allows diverse-owned business to report their status through self-certification. If you business meets the criteria of being 51% owned, operated and controlled by an individual or individuals that fall into one or more of the categories listed, please complete this section of the application.
By checking this box I affirm that the diversity information below is to my knowledge accurate and complete. I also affirm that I am authorized to report this information on behalf of my firm. I understand that this information may be used by Solidifi and its affiliates as part of its reporting obligations, and that falsification of this information may adversly affect my firm's ability to do business with Solidifi.
Self-Certify Diversity Membership
Minority Business Enterprise
Women Business Enterprise
Disabled Business Enterprise
Disabled Veteran Business Enterprise
Veteran Business Enterprise
Historically Underutilized Business Zone
Other: Please List Below
Prefer not to Disclose
Other Diversity Group
Gender
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Male
Female
Other
Prefer not to Disclose
Ethnicity
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African American
Asian Pacific American
Asian Subcontinent American
Native American
Hispanic American
Caucasian
Asian American
Other: Please List Below
Prefer not to Disclose
Other Ethnicity
Ancillary Information
Designations and Memberships
Tax ID
Do you have E&O Insurance?
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Yes
No
E&O Company
E&O Amount
Increment
Decrement
E&O Expiration Date
Years of Experience
Years of REO Experience
Initial Date of Licensure
Please list all states in which you have ever held a real estate license
Have you ever had any disciplinary action relating to any active or inactive license? If yes, please upload any documentation you have below.
Yes
No
Additional Documents
Please correct the following errors.
W9 Document
*Required
E & O Document
*Required
License Document
*Required
License Disciplinary Document
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or call (888) 999-6808. Copyright © 2017 Solidifi All rights reserved.
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