COMMISSION DISBURSEMENT AUTHORIZATION

1 First United Realty, 360 Driver Circle Court, Alpharetta, GA 30022 770-650-2825 Office Phone, 770-650-7352 Fax, COMMISSION DISBURSEMENT AUTHORIZATION Closing Agent / Law Firm name: Phone: Fax: Closer: Email address: Property Located at: Seller name: Buyer name: FUR Listing Agent Name: FUR Selling Agent Name: Sales Price: Closing Date: COMMISSION Paid to First United Realty: INSTRUCTIONS TO CLOSING AGENT / LAW FIRM: First United Realty authorizes the COMMISSION of to be paid in the following manner by separate checks and delivered as indicated below.

2 $ to PAY DIRECTLY TO FUR AGENT $ to FIRST UNITED REALTY Mail the check and final HUD-1 to: First United Realty 360 Driver Circle Court Alpharetta, GA 30022 ** IMPORTANT MESSAGE FOR THE CLOSER FOR THIS TRANSACTION: 1. IF THIS FORM IS NOT SIGNED BY THE AUTHORIZED SIGNER LISTED BELOW, 100% OF THE COMMISSION DUE TO FIRST UNITED REALTY MUST BE MADE PAYABLE TO FIRST UNITED REALTY. 2. SALES AGENTS DO NOT HAVE AUTHORIZATION TO MODIFY THIS FORM IN ANY WAY.

3 3. IF YOUR AMOUNTS DIFFER FROM THIS AUTHORIZATION FORM, YOU MUST OBTAIN A REVISED AUTHORIZATION FORM FROM THE OFFICE. 4. FIRST UNITED REALTY. CHECK MUST EQUAL THE DOLLAR AMOUNT LISTED ABOVE. Authorized Signature ONLY / Roman Feigin / Principal Broker Date