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Application for Patent License

Organization Information
Legal Name Street Address City ST ZIP Code Contact Phone E-Mail Address Legal Counsel (Optional) Legal Counsel Contact Info Subscriber Information Total # Paying Subscribers and Participants as of May 1st Attach billing summary showing total number of paying subscribers and participants Primary MLS Vendor Secondary MLS Vendor Public Records Vendors Attach list of all Vendors including public web site vendors, IDX vendors and all providing search capabilities

Type of Organization

___Broker Owned ___Combination

___REALTOR Association Owned (Attach list of all shareholders) ___Other

Submit Form with Executed License Agreement and Check Made Payable to NAR
Please send by overnight mail, addressed to: Laurene K. Janik, General Counsel National Association of Realtors 430 North Michigan Avenue

Chicago, IL 60611

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