Real Estate Broker Commission Claim Form
This form allows individuals who sold homes during the eligible date range to claim compensation for commissions paid. Interested users can fill out the form online or by mail to request their compensation. Ensure all information is provided accurately to avoid any claim rejection.
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How do I fill this out?
To fill out this Claim Form, first gather all necessary documentation related to your home sale. Ensure that all required sections are completed accurately. Review the Settlement Notice for guidelines before submission.

How to fill out the Real Estate Broker Commission Claim Form?
1
Obtain the Claim Form and Settlement Notice.
2
Gather all necessary sale documentation such as closing statements.
3
Fill in all sections of the Claim Form accurately.
4
Review your completed form for any missing information.
5
Submit your Claim Form online or by mail by the deadline.
Who needs the Real Estate Broker Commission Claim Form?
1
Home sellers who paid commissions to real estate agents.
2
Individuals who listed their homes on multiple listing services.
3
People looking to claim compensation from real estate transactions.
4
Anyone who sold their home during the eligible date range.
5
Real estate agents seeking to assist their clients with the claim.
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What are the instructions for submitting this form?
To submit this form, you have the option to do so electronically via the provided online portal or by mailing it to JND Legal Administration at PO Box 91479, Seattle, WA 98111. If submitting by mail, ensure that your envelope is postmarked no later than May 9, 2025. It’s advisable to keep copies of your submitted form and supporting documentation for your records.
What are the important dates for this form in 2024 and 2025?
The crucial date for submitting your Claim Form is May 9, 2025. Any claims postmarked or submitted after this date will be deemed ineligible for compensation. Be sure to gather all necessary documentation well in advance of this deadline.

What is the purpose of this form?
The purpose of the Real Estate Broker Commission Claim Form is to facilitate the process for individuals seeking reimbursement for commissions paid to real estate agents or brokers during an eligible period. This form is essential for documenting sales and ensuring rightful claims can be made under the settlement agreement. By completing this form accurately, claimants can receive compensation for fees incurred.

Tell me about this form and its components and fields line-by-line.

- 1. First Name: The claimant's given name.
- 2. M.I.: Middle initial of the claimant.
- 3. Last Name: The claimant's family name.
- 4. Current Address: Complete address including street, city, state, and zip code.
- 5. Email Address: Valid email for correspondence.
- 6. Phone Number: Contact number for follow-up.
- 7. Preferred Method of Payment: Options for how the claimant wishes to receive payment.
- 8. Address of Home Sold: Include the full address of the property sold.
- 9. Date of Sale: The official date when the sale occurred.
- 10. Approximate Home Sale Price: Estimated selling price of the home.
- 11. Listing Brokerage: Agency or brokerage that listed the home.
- 12. Amount of Total Commission Paid: Total commission fee paid to agents.
- 13. Amount of Commission Paid to Buyer-Side Broker: Commission specifically paid to the broker representing the buyer.
What happens if I fail to submit this form?
If you fail to submit this form, you will miss the opportunity to receive compensation for the commissions paid. Incomplete submissions will lead to rejection, preventing you from obtaining any potential reimbursement. Thus, it is important to ensure all sections are filled out accurately.
- Missing Information: Claims lacking essential details may be rejected.
- Late Submission: Submissions postmarked after the deadline will not be considered.
- Incorrect Documentation: Providing incorrect or invalid documents can lead to claim denial.
How do I know when to use this form?

- 1. Home Sale Claims: Individuals looking to claim for commissions paid on home sales.
- 2. Agent Support: Real estate agents assisting their clients with compensation claims.
- 3. Settlement Participation: Anyone eligible under the settlement agreement.
Frequently Asked Questions
What is the purpose of this Claim Form?
The Claim Form is designed for individuals seeking compensation for real estate broker commissions paid during the eligible period.
How do I submit the Claim Form electronically?
You can submit the Claim Form through the designated online portal by following the instructions provided.
What types of documentation do I need?
You will need closing statements or proof of payment to support your claim.
Can I submit multiple claims?
Yes, if you sold multiple homes, please submit a separate claim for each sale.
What is the deadline for submission?
Your Claim Form must be submitted by May 9, 2025.
Where can I track the status of my claim?
You can visit the official website to check your claim status and get updates.
Is there a fee to file the claim?
No, filing the claim is free of charge.
What if I need help completing this form?
You can contact the customer service number for assistance with the form.
What happens after I submit my claim?
Your claim will be reviewed by the Settlement Administrator for approval.
How will I receive my compensation?
Compensation will be provided via your chosen method of payment indicated on your form.
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