Broker Referral Request Form (LF) - Investing in Communities®

Find a broker. Make a difference!

When you use IIC to find and choose a broker, your favorite charity gets free funding ($1,300 for a typical $300,000 home sale). We provide three objectively qualified broker choices, or we can make arrangements with a broker you have in mind.

Type of Transaction*

Full Name*

First Last

Email*

Phone*

Home Sale or Purchase

Price Range*

Desired Date of Closing*

MM

DD

YYYY

Number of Bedrooms*

Number of Bathrooms*

Address of Home to Sell*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Desired City/Community and Area(s)

Desired Zip Code (if known)

Type of Property

Condo
Single Family Home

Description

Commercial Lease, Purchase, or Sale

Please specify area of city (if selling) and desired area(s) if buying or leasing.

Desired listing date (if selling) or desired occupancy date (if leasing or buying)

MM

DD

YYYY

If buying,or leasing, desired caliber; if selling, designated caliber of property

Class A
Class B
Class C

Type of Space

Office
Retail
Warehouse/Industrial
Medical
Other

If Other*

Square Footage

1,000
1,000-5,000
5,000-10,000
10,000-20,000
20,000-50,000
50,000+

Select your favorite IIC-listed charity.

If your favorite charity is not listed in our searchable charity member directory, please contact us at info@iiconline.org;

Is your favorite charity listed?

Yes
No

What is the name of the Charity?

Do you have more than one favorite charity?

Yes

Add a second charity here, and then adjust the allocation percentages below.

1st Charity Percentage*

Please enter a number from 0 to 100.

2nd Charity Percentage*

Please enter a number from 0 to 100.

How did you hear about IIC?

Please provide an email or name of the charity, company, or individual.

Have a Broker in Mind?*

Yes! (IIC will make the arrangements so your favorite charity can benefit.)
No (IIC will provide you with several brokers specifically qualified for your transaction.)

Broker's Name*

Broker's Email Address*

Phone

Language Preference or Other Special Qualifications

Home Buyers/Sellers

Find a broker. Make a difference!

Home Sale or Purchase

Commercial Lease, Purchase, or Sale