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Agent Email or Fax DISBURSEMENT AUTHORIZATION FORM DATE Texas United Realty 10920 Grant Rd. Houston Texas 77070 Agent Name License Exp. Date Phone 832-237-9200 Fax 281-310-5074 Email TexasUnited att. net Agent Phone Comp Plan GF Property Address Buyer and Phone Buyer has obtained survey Yes No rejection letter attached Seller and Phone Sales Price Title Company Closer Phone Number Fax Number Email When signed below Texas United Realty authorizes commission of Delivered as indicated* Agent...

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