name: date: cell phone: home phone: d.o.b. s.s.n.# date: cell phone: home phone: email: ... j. agent...

Name: Date:

Cell Phone:

Home Phone:

Email:

Emergency Contact Name:

Emergency Contact Number:

Home Address:

D.O.B. S.S.N.#

Do you have your real estate license? YES No

If Yes:

How long have you had your license? How many transactions have you completed? 0 1-3 4-5 6+

What company are you with? How long have you been at your company?

How many units have you closed this year? What is your GCI (Gross Commission Income) this year?

Are you a member of Ventura Board of Realtors? YES NO

Are you a member of any other Boards? YES NO

If so, which ones?

Do you have a Zipforms Account? YES NO

ZipForms Log in username: Password:

If No:

When do you expect to receive your license?

Will you be working full time in real estate?

What annual earnings do you expect to achieve your first year?

How did you learn about Keller Williams?

What is the #1 thing you’re looking for from Keller Williams?

Tell us about yourself (background, interests, goals, etc.)

I hereby certify that all above statements are true and I have not knowingly withheld any fact or circumstance which if disclosed, would adversely affect

my application.

SIGNATURE:_____________________________________________________________________________________________________________

2831 North Ventura Road, Oxnard, CA 93036

Independent Contractor Agreement

This Independent Contractor Agreement (‘Agreement’) is entered into by and between Vivaldi Holdings, Inc., a California Corporation, dba KELLER WILLIAMS REALTY/West Ventura County (“KELLER WILLIAMS,” the “Company,” or “Licensee”) and the undersigned Agent, sometimes referred to as "Agent” or “I.” KELLER WILLIAMS and the Agent agree as follows: 1. General Terms of Agreement

A. I understand that KELLER WILLIAMS Agents are independent contractors engaged in the business of providing real estate services to consumers. I understand that KELLER WILLIAMS has the right to instruct me as to the services I am to perform but does not have the right to instruct me as to the manner in which such services are performed because my relationship with KELLER WILLIAMS is as an independent contractor, not as an employee.

B. I understand that an essential part of this Agreement with KELLER WILLIAMS is that I will at all times protect the good name and reputation of KELLER WILLIAMS and will not do anything by action, association, or otherwise to cause damage to or harm the name or reputation of KELLER WILLIAMS.

C. I understand that I may sponsor and recommend other agents to be independent contractors with KELLER WILLIAMS. I agree to use care in recruiting new agents so that they will properly serve the needs of the public and be a credit to KELLER WILLIAMS. The terms of this program are outlined in the Keller Williams Realty National Policy & Guidelines Manual (“Policies & Guidelines Manual”) which is incorporated herein by reference.

D. I represent to KELLER WILLIAMS that I am a licensed salesperson and authorized to act as a Real Estate Salesperson in the State of California as an associate. If I fail to maintain a valid license, this Agreement shall terminate. I further agree that KELLER WILLIAMS will not be liable for withholding or payment of any taxes (local, state, or federal) or payment of my fees or business expenses other than those explicitly set out in the Agreement. Extraordinary or miscellaneous expenses, such as attorney’s fees and costs, which become necessary to obtain or defend any commission entitlement, or to defend any claim, shall be payable first from commission and be paid by the parties in the same proportion as provided for in the division of commissions. I agree to furnish my transportation at my own expense for carrying out my duties under this Agreement and to add KELLER WILLIAMS as an additional insured on my car insurance policy.

E. I agree to work diligently and to give my best effort to sell, lease, or rent any and all real estate listed with KELLER WILLIAMS available to me under the terms of this Agreement. I also agree to solicit additional listings and customers in the name of KELLER WILLIAMS and otherwise to promote this business of serving the public in real estate transactions.

F. I agree that all income from work performed with KELLER WILLIAMS will be disbursed under the terms of this Agreement, the Commission Agreement, and the Policies & Guidelines Manual. If I violate this provision and collect a fee or commission in my name or in the name of any third party from whom I expect to receive a portion of such income, I will forfeit any accrued but uncollected commissions in payment for the damage to KELLER WILLIAMS suffered as a result of my violation of this contract, in addition to being liable for any improper payments received. I also agree to reimburse KELLER WILLIAMS for all attorney’s fees and costs incurred by KELLER WILLIAMS if KELLER WILLIAMS determines, in its sole discretion, that it has to retain an attorney to collect any commissions due KELLER WILLIAMS resulting from my violation of this agreement.

G. I understand that KELLER WILLIAMS is a member of local Realtor associations, the California Association of Realtors, and the National Association Of Realtors. Agent agrees to conduct business in compliance with the standards of Agent conduct prescribed by Keller Williams Realty; with local, state and federal laws that govern real estate brokerage; and with the By-Laws and Codes of Ethics of each trade or professional organization of which Agent or Company is a member. I agree that I will comply strictly with: this Agreement; the laws of the State of California pertaining to real estate brokerage; and other business contracts, professional association rules and regulations, including without limitation those of the local Multiple Listing Service; all federal, state, and local laws, ordinances and regulations governing any such contract or any aspect of my business. Without limiting the generality of these commitments, Agent agrees:

(1) to comply with all laws and all Keller Williams Policies and Guidelines that apply to the dissemination of unsolicited e-mail (“spam”) and faxes and to the use of telephone calls to market Agent’s services or to solicit listings or prospective buyers;

(2) to adhere to and comply with the Privacy Policy that Keller Williams publishes from time to time for the www.kw.com website and with the terms of use that Keller Williams prescribes from time to time for the Keller Williams Intranet;

(3) to adhere to and comply with Keller Williams’ guidelines and restrictions that apply (i) to the registration, ownership and use of domain names for websites that display the Keller Williams trademarks or logo, (ii) to the display and use of the Keller Williams name, trademarks and logo on the Internet, and (iii) to the use of metatags and other devices that attract Internet search engines to such websites; and

(4) during the entire time that Agent remains with the Company, Agent agrees to list all real estate listings that Agent

obtains, and to handle all of Agent’s real estate transactions in the name of KELLER WILLIAMS REALTY.

H. For as long as Agent’s association with the Company continues, Agent has permission to use the KELLER WILLIAMS REALTY name and logo on his or her yard signs, business cards, letterhead and other business forms, subject to Keller Williams' advance approval of the artwork and text. Licensee will arrange for Agent to have a listing on the www.kw.com website, but, without express permission from Keller Williams and compliance with any policies and procedures that Keller Williams imposes, Agent may not use the Keller Williams name or logo on, or in the domain name, URL or metatags of, any website with which Agent is associated or in any Internet advertisement that Agent places. When Agent's association with the Company terminates, his or her permission to use the KELLER WILLIAMS REALTY name and logo will unconditionally cease, and Agent must immediately destroy all business forms that associate Agent with the Keller Williams organization and must comply with Keller Williams’ guidelines and procedures regarding website abandonment or revisions. If, with Keller Williams’ permission, Agent has used any variation of the KELLER WILLIAMS REALTY name or initials in a domain name, Agent will immediately transfer registration of the domain name to Keller Williams without compensation.

I. Agent agrees that if Agent does not pay accrued fees in full when due, the Company may deduct any unpaid amount plus penalty from Agent’s commissions.

J. Agent represents to Licensee that:

(1) Agent is duly licensed as a real estate broker or salesperson in the state of California and that Agent is currently authorized and able to act as such in the state of California;

(2) Agent is not now, and has not been within the last five years, a defendant in any lawsuit alleging professional misconduct or violation of any deceptive trade practices/consumer protection law, nor is Agent currently subject to an investigation by a real estate commission or comparable oversight body;

(3) Agent has disclosed to the Company: any prior convictions, suspensions of any professional license that Agent now holds or has held, and any disciplinary action taken by any real estate board or licensing body or any other professional licensing board or body related or unrelated to real estate;

(4) Agent expressly represents and warrants that Agent is free to associate with the Company and that Agent is not bound by a promise or commitment to any other real estate company, agency, association, firm, person or corporation that prohibits or prevents Agent from associating with the Keller Williams organization; and

(5) No representative of Licensee or Keller Williams has represented that Agent can earn a living selling real estate, whether working part-time or full-time. Agent recognizes that the predominant method of earning income in the Keller Williams organization is through the sale of real estate, and that any recruiting-based income an agent may earn is purely supplemental.

2. Indemnification of KELLER WILLIAMS

A. I agree to indemnify and hold harmless KELLER WILLIAMS and its officers, directors and employees, the officers, directors, and employees of any subsidiaries or related companies, whether such officers, directors and employees are acting in their official capacities or not, (all of the foregoing are collectively and severally referred to herein as the "Indemnified Party”) from and against any and all liability, claims, demands, proceedings, obligations, assessments, loss, cost, damage or expense, of any nature whatsoever contingent or otherwise (including without Iimitation any and all judgments, decrees, equitable relief, extraordinary relief, settlements, awards, attorneys fees, court costs, punitive damages and arbitration costs including arbitrators’ fees) (collectively and severally, "Indemnified Loss”) which are incurred arise out of, or in connection with any material breach of this Agreement or by negligent or willful misconduct by Agent.

B. To secure as an offset, but not as complete payment of any such loss associated with my indemnification, I hereby assign to

KELLER WILLIAMS any commissions (or advances thereon) otherwise payable to me to the extent necessary to satisfy KELLER WILLIAMS for any such Indemnified Loss.

3. Independent Contractor

A. I understand that I am an independent contractor under this Agreement which authorizes me to conduct this business and I am free to control my business, my business hours, my choice of customers and my sales methods, all subject, however to compliance with all KELLER WILLIAMS Policies and Guidelines, applicable local, state and federal laws and regulations, and the regulations of any trade or professional organizations of which KELLER WILLIAMS is a member. I further understand that my independent contractor status shall remain intact, notwithstanding any contractor designation or terminology which may appear on any state license or form. However, if the courts decide that notwithstanding this stipulation, I am an employee of KELLER WILLIAMS, then I elect and hereby give notice in advance that I reserve all of my rights at common law and under the statues of the state in which I am licensed to Sell or broker real estate.

B. I promise that I shall not: (1) sign any contract including, but not limited to the purchase or lease of office equipment, in the name of the Company; (2) open or continue to have any bank account, checking or savings, or any other investment account in the name of the Company; (3) open any charge or secure credit in the name of the Company; (4) negotiate or deposit in my personal account any check, money order or similar instrument made payable to KELLER WILLIAMS or the Company (5) incur any expense in the name of the Company.

4. Restrictive Covenants and Confidential Information

A. I recognize that KELLER WILLIAMS has spent a considerable amount of time, effort, money and skills in developing its business and its customer list. The names of the customers and agents solicited for KELLER WILLIAMS constitute a valuable business asset of KELLER WILLIAMS and these assets shall be treated as the confidential information of KELLER WILLIAMS and shall be

considered a trade secret under law. All customers and listings solicited by me constitute my business and should I ever leav e KELLER WILLIAMS, I am entitled to retain these customers and listings upon my departure.

B. I promise that I will not directly or indirectly, during the term of this Agreement and for a period of one (1) year thereafter, divulge sell, exchange or distribute to any person or entity outside of KELLER WILLIAMS the identities of or any list of names (written or otherwise) of customers, agents or any other similar confidential information of KELLER WILLIAMS nor will I utili ze such lists or other confidential information except in connection with the business of KELLER WILLIAMS.

C. I agree that I will not directly or indirectly, during the term of the Agreement and for the period of one (1) year thereafter, solicit or recruit, or attempt to solicit or recruit, for employment or for independent contract with any real estate broker or any other real estate organization, any agent or other employee of KELLER WILLIAMS.

D. The territorial limitation for subparagraph 4 shall be a radius of 50 (fifty) miles from Agent’s Principal Address (as defined below), as it existed at the time of the termination of this Agreement. For purposes of this subsection 4D, my Agent’s Principal Address shall be my home address and as changed by me by notice as required by this Agreement.

E. I expressly recognize and acknowledge that KELLER WILLIAMS would suffer extremely costly and irreparable harm, loss and damage if I (for myself or on behalf of any other person, partnership, corporation or other entity by whom I may be subsequently employed, or with whom I may contract) should violate any of these covenants and that in the event I were to violate any of the above covenants, KELLER WILLIAMS’ recovery of damages although proper would be inadequate and thus courts or arbitrators with competent jurisdiction shall issue injunctive relief and specific performance and shall enjoin any further violations of these covenants. I expressly acknowledge and stipulate that injunctive relief is appropriate and necessary in the event of a violation because there may be no adequate remedy at law for a violation of any of the covenants.

F. In the event of any breach by Agent of this Section 4 then, in addition to any other rights or remedies of KELLER WILLIAMS, where by law or in equity, Agent shall lose all rights to any further commissions.

G. The agreements and covenants contained in this Agreement are severable and separate, and the unenforceability of any specific agreement or covenant herein shall not affect the validity of any other. These agreements and covenants on the part of Agent shall be construed as independent of any other provision in this Agreement and the existence of any claim or cause of action of Agent, whether predicated in this Agreement or otherwise shall not constitute a defense to these agreements and covenants.

5. KELLER WILLIAMS Policies and Guidelines

A. I hereby acknowledge that I will read in its entirety prior to commencement of any activity subject to this Independent Contractor Agreement, the Keller Williams Realty National Policy & Guidelines Manual and agree to comply with all policies and guidelines as set out therein. The KELLER WILLIAMS Policies and Guidelines are a part of my Agreement and my failure to comply is a breach of this Agreement and can result in its termination.

B. AGENT ACKNOWLEDGES THAT KELLER WILLIAMS MAY AMEND THE POLICIES AND GUIDELINES AT ANY TIME. AGENT IS RESPONSIBLE TO KEEP UP WITH ALL POLICIES AND GUIDELINES AND AGREES TO COMPLY WITH ANY SUCH AMENDED POLICIES AND GUIDELINES.

C. In the event I should receive a profit share check that is an overpayment (whether I am with KELLER WILLIAMS or not) I will immediately remit the difference or return the erroneous check so that a corrected check may be issued.

D. I understand that receipt of profit share checks is subject to certain limitations including, but not limited to: tenure of Agent with Keller Williams Realty and the profitability of Market Centers. By way of example, an agent who terminates his/her relationship with a Keller Williams Realty Market Center prior to vestiture will lose any and all rights to receive any future profit and share unless said agent makes application to join another Keller Williams Market Center within 72 hours of such termination. The entire policy as it relates to these issues has been read in the Policies and Guidelines Manual and has been accepted by the Agent.

6. Term and Termination

A. Either Agent or KELLER WILLIAMS may terminate this Agreement at any time, with written notice, with or without reason or cause. B. Termination of this Agreement shall not terminate any of the continuing rights or obligations of either Agent or KELLER WILLIAMS if

the parties contemplated such rights and obligations would survive termination of this Agreement. C. If I owe KELLER WILLIAMS REALTY International or any Keller Williams Market Centers any amounts at the time of termi nation of

this Agreement or if any amounts become due from me to KELLER WILLIAMS REALTY after the termination, I authorize KELLER WILLIAMS to deduct these amounts from any commissions, profit share checks or other amounts due to me from KELLER WILLIAMS until the amounts owed KELLER WILLIAMS have been fully paid.

Miscellaneous Provisions

A. The failure or delay by any party hereto to insist upon strict performance of the terms and conditions of this Agreement shal l not be deemed a waiver of any of the rights or remedies that such party may have and shall not be deemed a waiver of any subsequent breach or default in the terms hereof. To be effective, any waiver must be in writing and signed by the party granting the waiver and any such waiver shall apply only to the matter or instance so specifically waived.

B. Titles and heading of sections and subsections or any other parts of the Agreement are for convenience only and are not intended to reflect or restrict, or to encompass all other provisions therein or to interpret or govern such provisions. The provisions themselves shall control.

C. If any part, section, clause, paragraph, term or provision of this Agreement shall be found to be void or unenforceable by any court or arbitration of competent jurisdiction, such finding shall have no effect upon any other part, section, clause, paragraph, term or provision of the Agreement, and all other parts, sections, clauses, paragraphs, terms and provisions shall be given full force and effect.

D. Agent may not assign any rights or delegate any duties under this Agreement except as expressly herein provided. This Agreement and the rights of the parties thereunder shall be binding upon and inure to the benefit of the parties thereto and their respective heirs, legal representatives and successors, to the extent herein allowed.

E. As used herein, the masculine and feminine shall also refer, as applicable, to the feminine and masculine.

F. In the event that any party hereto commences an action or arbitration to enforce or interpret any of the provisions hereof, the prevailing party in such action shall be entitled to an award of its reasonable attorney’s fees and all costs and expenses incurred in connection therewith.

G. Certain provisions of this Agreement by their nature provide post-termination protection and rights to the parties and accordingly, shall survive termination of the Agreement. Such provisions so surviving shall be determined by reasonable construction of and by the nature of the particular provision.

H. This Agreement, including any Policies and Guidelines issued in accordance with this Agreement, constitute the entire agreement and understanding between the parties hereto and supersede any prior agreement which is intended by its nature to survive is preserved. Agent has not relied upon any representations, whether oral or written and regardless of by whom made, in entering into this Agreement not herein contained. No change, amendment, termination or attempted waiver of any of the provisions hereof shall be binding upon KELLER WILLIAMS unless in writing and signed by KELLER WILLIAMS.

I. This contract is not binding until received and accepted by KELLER WILLIAMS as acknowledged by signing. J. I understand that no Attorney General or other regulatory authority ever reviews, endorses or approves any sales or marketing

program and I will not claim that any such review, endorsement or approval has occurred. Should I have questions concerning the compliance of KELLER WILLIAMS with applicable laws, I, or my attorney may direct inquiries to the KELLER WILLIAMS Legal Department.

K. I will not state or infer that an actual or typical earnings or commissionable sales organization group may be built or maintained, as I understand that there is no established average or typical monthly or other earnings which may be anticipated by my association with KELLER WILLIAMS.

L. Each KELLER WILLIAMS agent pays a one-time Associate Application Fee (upon hire) and an annual Associate Renewal Fee (every January.)

M. In the event of dispute between KELLER WILLIAMS and Agent arising under this Agreement, it is agreed that such disputes shall be exclusively resolved by binding arbitration under the Commercial Rules of the American Arbitration Association with arbitration shall occur in Los Angeles County and the arbitrator is entitled to award reasonable attorneys' fees.

Commission Agreement:

A. Annual Commission Cap: $26,000 ($23,000 to KW West Ventura, $3,000 to KWRI) B. Agent commission Split: _________________________

Agent’s Name: Date:

Agent’s Signature:

Vivaldi Holdings, Inc. dba Keller Williams Realty West Ventura County

2831 North Ventura Road, Oxnard, CA 93036

Nancy Amorteguy, Team Leader Date:

Signature:

Binding Sponsorship AgreementPrint Date: April 10,2014 MC#: 835 West Ventura County

Associate's

InitialsChoosing a SponsorChoosing a Sponsor is a very important decision that you must consider wisely since the person you choose will be your “sponsor for life.” The Profit Share System was implemented to reward Keller Williams Realty associates and employees for helping build the company by attracting additional talented and productive members. ________

The “Spirit of the System” is that the person named as your sponsor is that person whom you feel is primarily responsible for bringing you to Keller Williams Realty. In fact, it may or may not be the first or last person who talked to you about joining. You may over time have met with many people in the company. Your Sponsor should be the person most instrumental in bringing you to serious discussions. It is similar to the procuring cause issue that is traditional in the real estate business. ________

Any person in a leadership position is ethically bound to honor leads given to them by other Keller Williams Realty family members. ________

While you may initially consider one of the following leaders as your sponsor because they made personal contact with you, that leader must ensure that you name the person who actually referred you to them as your Sponsor. You should know that any person in a leadership position is ethically bound to honor leads given to them by other Keller Williams Realty family members. These leadership positions include:

* Market Center Owner/Team Leader/Administrator* Regional Owner/Director/Administrator* Keller Williams Realty, Inc. Executives and Staff ________

Additionally, sponsorship is NOT related to the following:

1. Whose team you join.2. Any promises to help you.3. Any benefit offered you to join.4. Any promise to mentor.5. Someone wanting or thinking or asking that they be your Sponsor.6. The Team Leader’s presentation. ________

You are the sole person with the right to name your Keller Williams Realty Profit Share Sponsor — any future profit sharing benefits should be given to the person whom you believe actually helped us grow because they brought you to us. We honor your rights because your affiliation with us adds value to the entire Keller Williams Realty family. ________

Positioning in the Profit Share TreeIf you join Keller Williams Realty and are the primary reason others come along with you (spouse, family member, partner, staff, etc.) you may want to consider how you/they are “stacked” in the Keller Williams Realty Profit Share Sponsorship Tree. After you choose your primary Sponsor, others, if they choose, may then name you as their sponsor. You may do this in such a way as to maximize the Profit Share you can receive. For example, a husband and wife may decide to have the producing spouse name the other spouse as their sponsor so that they may actually receive Profit Share from their own family’s production. ________

If you bring family or team members, the only requirement is that they are ACTIVELY in the real estate business with you. If they are an administrative staff member, they do not need to be licensed to receive Profit Share. Once with Keller Williams Realty, you and each of your family or team members may also sponsor new people who can then build their own Profit Share Tree. Please discuss all of this with the Team Leader or Operating Principal of the Keller Williams Market Center you are joining. You want to make the right decisions now, because YOU WON’T BE ABLE TO CHANGE YOUR DECISION LATER. ________

Binding Sponsorship Agreement, v06/13/2013 Page 1 of 5


Formal Designation of SponsorFully understanding the meaning of Sponsorship, the undersigned hereby designates:

First:_______________________ Middle:_______________________ Last:_______________________Name of Permanent Sponsor

___________________________________City, State

___________________________________Market Center (if known)

as his/her Permanent Sponsor for purposes of the Keller Williams Realty Profit Sharing system. The undersigned, by execution hereof, understands that the designation of a Sponsor, once executed, can only be changed as follows: ________

1. SUBSTITUTE SPONSORSHIP (Section 4, Policies and Guidelines Manual)The Associate’s Permanent Sponsor ___________________________________, has not yet joined Keller Williams Realty. If he/she joins WITHIN 90 DAYS OF THE ASSOCIATE’S START DATE*, and the Associate informs the MCA and TL, in writing, WITHIN 90 DAYS OF THE ASSOCIATE’S START DATE*, the Associate’s Substitute Sponsor will be replaced by ___________________________________ as the Associate’s Permanent Sponsor. ________

Because the Permanent Sponsor designated above has not yet joined Keller Williams Realty, the Associate hereby designates ___________________________________ to be their Substitute Sponsor, and understands this individual will automatically become their Permanent Sponsor unless written notification is given WITHIN THE FIRST 90 DAYS AS NOTED ABOVE*. Notification of the change from Substitute to Permanent Sponsor, using the ASSOCIATE SPONSOR CORRECTION FORM in the MORE system, must be signed by the Associate, Current Sponsor, New Sponsor, Team Leader and Regional Director, and forwarded to the KWRI MORE Administrator, ALL WITHIN 90 DAYS FROM THE ASSOCIATE’S START DATE*. ________

No change will be made if:- the Permanent Sponsor designated above by the Associate, does not join Keller Williams Realty WITHIN 90 DAYS OF THE ASSOCIATE’S START DATE*;- the proper notices are not given as noted above; or- the ASSOCIATE SPONSOR CORRECTION FORM is not completely executed and submitted to KWRI’s MORE Administrator WITHIN THE 90 DAY PERIOD*. ________

IT IS THE ASSOCIATE’S RESPONSIBILITY TO ENSURE THAT HIS/HER SPONSOR IS PROPERLY CHANGED WITHIN THIS TIME FRAME. ________

* For an Associate that joins Keller Williams Realty as part of a new Market Center launch, the 90-day grace period begins on the first day of the month that the new Market Center transmits for the first time.



2. CHANGE OF SPONSORSHIP - CLERICAL MISTAKE (Section 4, Policies and Guidelines Manual)A clerical mistake can be corrected ONLY WITHIN 90 DAYS OF THE ASSOCIATE’S START DATE* by the Associate submitting a written statement of the clerical mistake to the Market Center, using the ASSOCIATE SPONSOR CORRECTION FORM in the MORE system. The ASSOCIATE SPONSOR CORRECTION FORM must be signed by the Associate, Current Sponsor, New Sponsor, Team Leader and Regional Director, and forwarded to the KWRI MORE Administrator, ALL WITHIN 90 DAYS OF THE ASSOCIATE’S START DATE*. ________

IT IS THE ASSOCIATE’S RESPONSIBILITY TO ENSURE THAT HIS/HER SPONSOR IS PROPERLY CORRECTED WITHIN THIS TIME FRAME. IF THE ERROR IS NOT NOTED AND CORRECTED WITHIN 90 DAYS OF ASSOCIATE’S START DATE*, THEN THE SPONSOR, AS ENTERED INTO THE MORE SYSTEM, WILL REMAIN UNCHANGED. ________

* For an Associate that joins Keller Williams Realty as part of a new Market Center launch, the 90-day grace period begins on the first day of the month that the new Market Center transmits for the first time.

3. CHANGE OF SPONSORSHIP AFTER AN ABSENCE OF 9 MONTHS OR LONGER(WHEN RETURNING TO ORIGINAL MARKET CENTER OR JOINING ANOTHER) (Non-Vested) (Section 4, Policies and Guidelines Manual)Individuals moving from one Keller Williams Realty location to another, individuals who go to work as an assistant or member of another associate’s team or group and individuals who leave Keller Williams Realty for a period of time and later return, all keep their original sponsors - unless they are away from the Keller Williams organization and removed from the Keller Williams Profit Share System for at least nine (9) months. Upon return, provided they were not vested at the time of departure, they may choose a new Permanent Sponsor only after the minimum 9-month period of absence. ________

Online Confirmation of SponsorThe undersigned Associate acknowledges that an online confirmation of his or her Permanent Sponsor is required. The purpose of the Online Confirmation of Sponsor is for the Associate to confirm that a clerical error was not made in the input of the Permanent Sponsor. ________

Associate AffirmationsI understand that Keller Williams Realty, Inc. and its authorized representatives (“KWRI”) have no financial interest in my designation of a Sponsor and that, in recording my Sponsor’s name, KWRI merely follows my instructions. ________

I understand that I will have no vested interest as a sponsor of any other Keller Williams Realty associate unless and until that person properly designates me as his or her sponsor in accordance with Keller Williams Realty policies and procedures. ________

I understand that, except for a per distribution Real Estate Associates Tracking System (RATS) fee for the administration of the Profit Sharing program, KWRI does not receive any part of a Market Center’s Profit Sharing contributions and does not otherwise share in or benefit financially from Profit Sharing contributions. ________

On the basis of these understandings and their consequences, I voluntarily waive and relinquish any claims I may have against KWRI on account of any disagreement over the designation of my Permanent Sponsor or my status as the sponsor of another participant in the Profit Sharing program, except in cases based on my good faith belief that KWRI has acted with actual malice toward me or in willful disregard for my rights. ________



Designation of BeneficiaryI hereby designate the following person or entity as my Beneficiary of my Account under the Keller Williams Profit Sharing Program payable in the event of my death.

I understand that if no beneficiary is designated, then in the event of my death KWRI must be notified of the following prior to making any change to whom distributions are paid: ________

o Beneficiary to whom future distributions are payable with documentation of the beneficiary as evidenced by court order, probated will, will ratified by the court, or similar document ________

o Tax ID# and address of beneficiary

___________________________________________Name of Beneficiary

___________________________________________Social Security Number/TIN#

___________________________________________Address

___________________________________________City, State

___________________________________________Date of Birth

___________________________________________Relationship to Associate*

* If you are married, and DO NOT designate your spouse as the beneficiary of your Profit Share distributions, your state may require that your spouse consent in writing to said designation in order for the designation to be upheld if challenged. A Consent of Spouse form is attached hereto for this purpose. KWRI is aware that some states do not require a Consent of Spouse and due to the reality that such laws change and KWRI is unable to determine which state’s laws may apply to an associate’s estate, KWRI encourages any married associate designating someone other than their spouse as their Profit Share beneficiary to have the attached consent form signed by their spouse before a Notary Public. ________

Executed and agreed to this _____ day of ____________________, 20_____.

___________________________________ ___________________________________Associate’s Printed Name Team Leader Signature

___________________________________ ___________________________________Associate’s Signature MCA Signature

___________________________________Witness to Associate’s Signature



Consent of Spouse to Designation of Beneficiary*

(* Only required if the Associate is married and does not designate his/her spouse as the beneficiary for his/her Profit Share distributions.)

I acknowledge that I am the spouse of ___________________________(the “Associate”). I hereby certify that I have read this Designation of Beneficiary information and understand that I may possess a beneficial interest in my spouse's account under the Keller Williams Profit Sharing Program if I survive him/her. I hereby acknowledge and consent to the Designation of Beneficiary. My consent shall be irrevocable unless my spouse subsequently changes the Designation of Beneficiary.

If my spouse changes the designation, [Choose EITHER (a) OR (b):]

[__] (a) I understand I must sign a new consent to the new designation for it to be effective.

[__] (b) I waive my right to consent to any future change in designation. I understand I have the right to restrict my consent only to the Beneficiary designated on this Form by checking box (a).

___________________________________Signature of Associate's Spouse

Date:______________________________

Notarization of Spouse’s Signature

___________________________________________STATE/PROVINCE OF

___________________________________________COUNTY OF

On this ______ day of ______________________________, 20______, before me appeared

______________________________________ who acknowledged herself or himself to be the person who executed the consent set forth above and acknowledged the consent to be his or her free act and deed.

______________________________________Notary Public

My Commission Expires:


Profit Share Direct Deposit Authorization

Keller Williams distributes Profit Share payments on a monthly basis. These payments are deposited directly to your checking account.

Please either:

a) Staple a VOIDED check to this form or,

b) Complete the form by hand using the information from a personal check. A sample check is pictured below to help you complete the form.

Bank Transit/ABA Account Number

Market Center Charge Account

Credit Card Information

For your monthly office bill, long distance phone charges, and special training events that you may wish to “put on your tab”, you are required to keep a credit card on file with the office.

Name (as it appears on credit card) :

Card Number: Verification Code (Numbers on Back) :

Card Type: VISA MC AMEX Expiration Date:

Billing Address:

o Same as my Mailing Address

o Different Address.

Please Record Billing Address:

By signing this, I authorize KW West Ventura County to charge my card. I will receive a monthly bill/receipt.

Signature:

Your Initial Investment is : __________________________

(please select one)

O I would like to pay my initial investment with the credit card above.

Your Monthly Investment will be approximately: _______________________

(please select one)

O I would like to pay my monthly office bill with the credit card above.

O I choose to pay my monthly bill via other means (i.e. check, cash, or money order). I authorize Keller Williams Realty West Ventura County to charge my credit card in the full balance if payment has not been made by the 20th of the month.

__________ If the credit card is declined and/or the check bounces and the full balance of the payment has

( initial ) not been made by the last day of the month, I recognize that I will be charged a late fee of $50.

Policies and Guidelines Manual Acknowledgement

I agree to read the Keller Williams National Policy & Guidelines Manual. A copy of this manual can be found on the mykw.kw.com home page. If I don’t fully understand any part of the manual, I will bring it to your attention. I agree to abide by the Policies and Guidelines set forth. ______________________________________ ___________________________ Associate Signature Date

Insurance Each sales associate must provide the company with evidence that he/she has secured and continues to maintain the appropriate endorsement on his/her automobile insurance policy in the minimum amount of $300,000/$100,000/$50,000, naming as additional insured: Vivaldi Holdings, Inc. dba Keller Williams Realty 2831 North Ventura Road Oxnard, CA 93036

Form W-9(Rev. December 2014)Department of the Treasury Internal Revenue Service

Request for Taxpayer Identification Number and Certification

Give Form to the requester. Do not send to the IRS.

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2.

1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.

2 Business name/disregarded entity name, if different from above

3 Check appropriate box for federal tax classification; check only one of the following seven boxes:

Individual/sole proprietor or single-member LLC

C Corporation S Corporation Partnership Trust/estate

Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership)

Note. For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for the tax classification of the single-member owner.

Other (see instructions)

4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3):Exempt payee code (if any)

Exemption from FATCA reporting

code (if any)(Applies to accounts maintained outside the U.S.)

5 Address (number, street, and apt. or suite no.)

6 City, state, and ZIP code

Requester’s name and address (optional)

7 List account number(s) here (optional)

Part I Taxpayer Identification Number (TIN)Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3.

Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter.

Social security number

– –

orEmployer identification number

–

Part II CertificationUnder penalties of perjury, I certify that:1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and

2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and

3. I am a U.S. citizen or other U.S. person (defined below); and4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 3.

Sign Here

Signature of U.S. person Date

General InstructionsSection references are to the Internal Revenue Code unless otherwise noted.

Future developments. Information about developments affecting Form W-9 (such as legislation enacted after we release it) is at www.irs.gov/fw9.

Purpose of FormAn individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following:

• Form 1099-INT (interest earned or paid)

• Form 1099-DIV (dividends, including those from stocks or mutual funds)

• Form 1099-MISC (various types of income, prizes, awards, or gross proceeds)

• Form 1099-B (stock or mutual fund sales and certain other transactions by brokers)

• Form 1099-S (proceeds from real estate transactions)

• Form 1099-K (merchant card and third party network transactions)

• Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition)

• Form 1099-C (canceled debt)

• Form 1099-A (acquisition or abandonment of secured property)

Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN.

If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding? on page 2.

By signing the filled-out form, you:

1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued),

2. Certify that you are not subject to backup withholding, or

3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income, and

4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. See What is FATCA reporting? on page 2 for further information.

Cat. No. 10231X Form W-9 (Rev. 12-2014)

Form W-9 (Rev. 12-2014) Page 2

Note. If you are a U.S. person and a requester gives you a form other than Form W-9 to request your TIN, you must use the requester’s form if it is substantially similar to this Form W-9.

Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are:

• An individual who is a U.S. citizen or U.S. resident alien;

• A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States;

• An estate (other than a foreign estate); or

• A domestic trust (as defined in Regulations section 301.7701-7).

Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax under section 1446 on any foreign partners’ share of effectively connected taxable income from such business. Further, in certain cases where a Form W-9 has not been received, the rules under section 1446 require a partnership to presume that a partner is a foreign person, and pay the section 1446 withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid section 1446 withholding on your share of partnership income.

In the cases below, the following person must give Form W-9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States:

• In the case of a disregarded entity with a U.S. owner, the U.S. owner of the disregarded entity and not the entity;

• In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally, the U.S. grantor or other U.S. owner of the grantor trust and not the trust; and

• In the case of a U.S. trust (other than a grantor trust), the U.S. trust (other than a grantor trust) and not the beneficiaries of the trust.

Foreign person. If you are a foreign person or the U.S. branch of a foreign bank that has elected to be treated as a U.S. person, do not use Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see Publication 515, Withholding of Tax on Nonresident Aliens and Foreign Entities).

Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. However, most tax treaties contain a provision known as a “saving clause.” Exceptions specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the payee has otherwise become a U.S. resident alien for tax purposes.

If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items:

1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien.

2. The treaty article addressing the income.

3. The article number (or location) in the tax treaty that contains the saving clause and its exceptions.

4. The type and amount of income that qualifies for the exemption from tax.

5. Sufficient facts to justify the exemption from tax under the terms of the treaty article.

Example. Article 20 of the U.S.-China income tax treaty allows an exemption from tax for scholarship income received by a Chinese student temporarily present in the United States. Under U.S. law, this student will become a resident alien for tax purposes if his or her stay in the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows the provisions of Article 20 to continue to apply even after the Chinese student becomes a resident alien of the United States. A Chinese student who qualifies for this exception (under paragraph 2 of the first protocol) and is relying on this exception to claim an exemption from tax on his or her scholarship or fellowship income would attach to Form W-9 a statement that includes the information described above to support that exemption.

If you are a nonresident alien or a foreign entity, give the requester the appropriate completed Form W-8 or Form 8233.

Backup WithholdingWhat is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS 28% of such payments. This is called “backup withholding.” Payments that may be subject to backup withholding include interest, tax-exempt interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, payments made in settlement of payment card and third party network transactions, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding.

You will not be subject to backup withholding on payments you receive if you give the requester your correct TIN, make the proper certifications, and report all your taxable interest and dividends on your tax return.

Payments you receive will be subject to backup withholding if: 1. You do not furnish your TIN to the requester,

2. You do not certify your TIN when required (see the Part II instructions on page 3 for details),

3. The IRS tells the requester that you furnished an incorrect TIN,

4. The IRS tells you that you are subject to backup withholding because you did not report all your interest and dividends on your tax return (for reportable interest and dividends only), or

5. You do not certify to the requester that you are not subject to backup withholding under 4 above (for reportable interest and dividend accounts opened after 1983 only).

Certain payees and payments are exempt from backup withholding. See Exempt payee code on page 3 and the separate Instructions for the Requester of Form W-9 for more information.

Also see Special rules for partnerships above.

What is FATCA reporting?The Foreign Account Tax Compliance Act (FATCA) requires a participating foreign financial institution to report all United States account holders that are specified United States persons. Certain payees are exempt from FATCA reporting. See Exemption from FATCA reporting code on page 3 and the Instructions for the Requester of Form W-9 for more information.

Updating Your InformationYou must provide updated information to any person to whom you claimed to be an exempt payee if you are no longer an exempt payee and anticipate receiving reportable payments in the future from this person. For example, you may need to provide updated information if you are a C corporation that elects to be an S corporation, or if you no longer are tax exempt. In addition, you must furnish a new Form W-9 if the name or TIN changes for the account; for example, if the grantor of a grantor trust dies.

PenaltiesFailure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect.

Civil penalty for false information with respect to withholding. If you make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $500 penalty.

Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment.

Misuse of TINs. If the requester discloses or uses TINs in violation of federal law, the requester may be subject to civil and criminal penalties.

Specific InstructionsLine 1You must enter one of the following on this line; do not leave this line blank. The name should match the name on your tax return.

If this Form W-9 is for a joint account, list first, and then circle, the name of the person or entity whose number you entered in Part I of Form W-9.

a. Individual. Generally, enter the name shown on your tax return. If you have changed your last name without informing the Social Security Administration (SSA) of the name change, enter your first name, the last name as shown on your social security card, and your new last name.

Note. ITIN applicant: Enter your individual name as it was entered on your Form W-7 application, line 1a. This should also be the same as the name you entered on the Form 1040/1040A/1040EZ you filed with your application.

b. Sole proprietor or single-member LLC. Enter your individual name as shown on your 1040/1040A/1040EZ on line 1. You may enter your business, trade, or “doing business as” (DBA) name on line 2.

c. Partnership, LLC that is not a single-member LLC, C Corporation, or S Corporation. Enter the entity's name as shown on the entity's tax return on line 1 and any business, trade, or DBA name on line 2.

d. Other entities. Enter your name as shown on required U.S. federal tax documents on line 1. This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or DBA name on line 2.

e. Disregarded entity. For U.S. federal tax purposes, an entity that is disregarded as an entity separate from its owner is treated as a “disregarded entity.” See Regulations section 301.7701-2(c)(2)(iii). Enter the owner's name on line 1. The name of the entity entered on line 1 should never be a disregarded entity. The name on line 1 should be the name shown on the income tax return on which the income should be reported. For example, if a foreign LLC that is treated as a disregarded entity for U.S. federal tax purposes has a single owner that is a U.S. person, the U.S. owner's name is required to be provided on line 1. If the direct owner of the entity is also a disregarded entity, enter the first owner that is not disregarded for federal tax purposes. Enter the disregarded entity's name on line 2, “Business name/disregarded entity name.” If the owner of the disregarded entity is a foreign person, the owner must complete an appropriate Form W-8 instead of a Form W-9. This is the case even if the foreign person has a U.S. TIN.


Line 2If you have a business name, trade name, DBA name, or disregarded entity name, you may enter it on line 2.

Line 3Check the appropriate box in line 3 for the U.S. federal tax classification of the person whose name is entered on line 1. Check only one box in line 3.

Limited Liability Company (LLC). If the name on line 1 is an LLC treated as a partnership for U.S. federal tax purposes, check the “Limited Liability Company” box and enter “P” in the space provided. If the LLC has filed Form 8832 or 2553 to be taxed as a corporation, check the “Limited Liability Company” box and in the space provided enter “C” for C corporation or “S” for S corporation. If it is a single-member LLC that is a disregarded entity, do not check the “Limited Liability Company” box; instead check the first box in line 3 “Individual/sole proprietor or single-member LLC.”

Line 4, ExemptionsIf you are exempt from backup withholding and/or FATCA reporting, enter in the appropriate space in line 4 any code(s) that may apply to you.

Exempt payee code.• Generally, individuals (including sole proprietors) are not exempt from backup withholding.

• Except as provided below, corporations are exempt from backup withholding for certain payments, including interest and dividends.

• Corporations are not exempt from backup withholding for payments made in settlement of payment card or third party network transactions.

• Corporations are not exempt from backup withholding with respect to attorneys' fees or gross proceeds paid to attorneys, and corporations that provide medical or health care services are not exempt with respect to payments reportable on Form 1099-MISC.

The following codes identify payees that are exempt from backup withholding. Enter the appropriate code in the space in line 4.

1—An organization exempt from tax under section 501(a), any IRA, or a custodial account under section 403(b)(7) if the account satisfies the requirements of section 401(f)(2)

2—The United States or any of its agencies or instrumentalities

3—A state, the District of Columbia, a U.S. commonwealth or possession, or any of their political subdivisions or instrumentalities

4—A foreign government or any of its political subdivisions, agencies, or instrumentalities

5—A corporation

6—A dealer in securities or commodities required to register in the United States, the District of Columbia, or a U.S. commonwealth or possession

7—A futures commission merchant registered with the Commodity Futures Trading Commission

8—A real estate investment trust

9—An entity registered at all times during the tax year under the Investment Company Act of 1940

10—A common trust fund operated by a bank under section 584(a)

11—A financial institution

12—A middleman known in the investment community as a nominee or custodian

13—A trust exempt from tax under section 664 or described in section 4947

The following chart shows types of payments that may be exempt from backup withholding. The chart applies to the exempt payees listed above, 1 through 13.

IF the payment is for . . . THEN the payment is exempt for . . .

Interest and dividend payments All exempt payees except for 7

Broker transactions Exempt payees 1 through 4 and 6 through 11 and all C corporations. S corporations must not enter an exempt payee code because they are exempt only for sales of noncovered securities acquired prior to 2012.

Barter exchange transactions and patronage dividends

Exempt payees 1 through 4

Payments over $600 required to be reported and direct sales over $5,0001

Generally, exempt payees 1 through 52

Payments made in settlement of payment card or third party network transactions

Exempt payees 1 through 4

1 See Form 1099-MISC, Miscellaneous Income, and its instructions.

2 However, the following payments made to a corporation and reportable on Form 1099-MISC are not exempt from backup withholding: medical and health care payments, attorneys' fees, gross proceeds paid to an attorney reportable under section 6045(f), and payments for services paid by a federal executive agency.

Exemption from FATCA reporting code. The following codes identify payees that are exempt from reporting under FATCA. These codes apply to persons submitting this form for accounts maintained outside of the United States by certain foreign financial institutions. Therefore, if you are only submitting this form for an account you hold in the United States, you may leave this field blank. Consult with the person requesting this form if you are uncertain if the financial institution is subject to these requirements. A requester may indicate that a code is not required by providing you with a Form W-9 with “Not Applicable” (or any similar indication) written or printed on the line for a FATCA exemption code.

A—An organization exempt from tax under section 501(a) or any individual retirement plan as defined in section 7701(a)(37)

B—The United States or any of its agencies or instrumentalities

C—A state, the District of Columbia, a U.S. commonwealth or possession, or any of their political subdivisions or instrumentalities

D—A corporation the stock of which is regularly traded on one or more established securities markets, as described in Regulations section 1.1472-1(c)(1)(i)

E—A corporation that is a member of the same expanded affiliated group as a corporation described in Regulations section 1.1472-1(c)(1)(i)

F—A dealer in securities, commodities, or derivative financial instruments (including notional principal contracts, futures, forwards, and options) that is registered as such under the laws of the United States or any state

G—A real estate investment trust

H—A regulated investment company as defined in section 851 or an entity registered at all times during the tax year under the Investment Company Act of 1940

I—A common trust fund as defined in section 584(a)

J—A bank as defined in section 581

K—A broker

L—A trust exempt from tax under section 664 or described in section 4947(a)(1)

M—A tax exempt trust under a section 403(b) plan or section 457(g) plan

Note. You may wish to consult with the financial institution requesting this form to determine whether the FATCA code and/or exempt payee code should be completed.

Line 5Enter your address (number, street, and apartment or suite number). This is where the requester of this Form W-9 will mail your information returns.

Line 6Enter your city, state, and ZIP code.

Part I. Taxpayer Identification Number (TIN)Enter your TIN in the appropriate box. If you are a resident alien and you do not have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer identification number (ITIN). Enter it in the social security number box. If you do not have an ITIN, see How to get a TIN below.

If you are a sole proprietor and you have an EIN, you may enter either your SSN or EIN. However, the IRS prefers that you use your SSN.

If you are a single-member LLC that is disregarded as an entity separate from its owner (see Limited Liability Company (LLC) on this page), enter the owner’s SSN (or EIN, if the owner has one). Do not enter the disregarded entity’s EIN. If the LLC is classified as a corporation or partnership, enter the entity’s EIN.

Note. See the chart on page 4 for further clarification of name and TIN combinations.

How to get a TIN. If you do not have a TIN, apply for one immediately. To apply for an SSN, get Form SS-5, Application for a Social Security Card, from your local SSA office or get this form online at www.ssa.gov. You may also get this form by calling 1-800-772-1213. Use Form W-7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS-4, Application for Employer Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS website at www.irs.gov/businesses and clicking on Employer Identification Number (EIN) under Starting a Business. You can get Forms W-7 and SS-4 from the IRS by visiting IRS.gov or by calling 1-800-TAX-FORM (1-800-829-3676).

If you are asked to complete Form W-9 but do not have a TIN, apply for a TIN and write “Applied For” in the space for the TIN, sign and date the form, and give it to the requester. For interest and dividend payments, and certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60-day rule does not apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester.

Note. Entering “Applied For” means that you have already applied for a TIN or that you intend to apply for one soon.

Caution: A disregarded U.S. entity that has a foreign owner must use the appropriate Form W-8.


Part II. CertificationTo establish to the withholding agent that you are a U.S. person, or resident alien, sign Form W-9. You may be requested to sign by the withholding agent even if items 1, 4, or 5 below indicate otherwise.

For a joint account, only the person whose TIN is shown in Part I should sign (when required). In the case of a disregarded entity, the person identified on line 1 must sign. Exempt payees, see Exempt payee code earlier.

Signature requirements. Complete the certification as indicated in items 1 through 5 below.

1. Interest, dividend, and barter exchange accounts opened before 1984 and broker accounts considered active during 1983. You must give your correct TIN, but you do not have to sign the certification.

2. Interest, dividend, broker, and barter exchange accounts opened after 1983 and broker accounts considered inactive during 1983. You must sign the certification or backup withholding will apply. If you are subject to backup withholding and you are merely providing your correct TIN to the requester, you must cross out item 2 in the certification before signing the form.

3. Real estate transactions. You must sign the certification. You may cross out item 2 of the certification.

4. Other payments. You must give your correct TIN, but you do not have to sign the certification unless you have been notified that you have previously given an incorrect TIN. “Other payments” include payments made in the course of the requester’s trade or business for rents, royalties, goods (other than bills for merchandise), medical and health care services (including payments to corporations), payments to a nonemployee for services, payments made in settlement of payment card and third party network transactions, payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attorneys (including payments to corporations).

5. Mortgage interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualified tuition program payments (under section 529), IRA, Coverdell ESA, Archer MSA or HSA contributions or distributions, and pension distributions. You must give your correct TIN, but you do not have to sign the certification.

What Name and Number To Give the RequesterFor this type of account: Give name and SSN of:

1. Individual The individual2. Two or more individuals (joint

account)The actual owner of the account or, if combined funds, the first individual on the account1

3. Custodian account of a minor (Uniform Gift to Minors Act)

The minor2

4. a. The usual revocable savings trust (grantor is also trustee) b. So-called trust account that is not a legal or valid trust under state law

The grantor-trustee1

The actual owner1

5. Sole proprietorship or disregarded entity owned by an individual

The owner3

6. Grantor trust filing under Optional Form 1099 Filing Method 1 (see Regulations section 1.671-4(b)(2)(i)(A))

The grantor*

For this type of account: Give name and EIN of:

7. Disregarded entity not owned by an individual

The owner

8. A valid trust, estate, or pension trust Legal entity4

9. Corporation or LLC electing corporate status on Form 8832 or Form 2553

The corporation

10. Association, club, religious, charitable, educational, or other tax-exempt organization

The organization

11. Partnership or multi-member LLC The partnership12. A broker or registered nominee The broker or nominee

13. Account with the Department of Agriculture in the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments

The public entity

14. Grantor trust filing under the Form 1041 Filing Method or the Optional Form 1099 Filing Method 2 (see Regulations section 1.671-4(b)(2)(i)(B))

The trust

1 List first and circle the name of the person whose number you furnish. If only one person on a joint account has an SSN, that person’s number must be furnished.

2 Circle the minor’s name and furnish the minor’s SSN.

3 You must show your individual name and you may also enter your business or DBA name on the “Business name/disregarded entity” name line. You may use either your SSN or EIN (if you have one), but the IRS encourages you to use your SSN.

4 List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN of the personal representative or trustee unless the legal entity itself is not designated in the account title.) Also see Special rules for partnerships on page 2.

*Note. Grantor also must provide a Form W-9 to trustee of trust.

Note. If no name is circled when more than one name is listed, the number will be considered to be that of the first name listed.

Secure Your Tax Records from Identity TheftIdentity theft occurs when someone uses your personal information such as your name, SSN, or other identifying information, without your permission, to commit fraud or other crimes. An identity thief may use your SSN to get a job or may file a tax return using your SSN to receive a refund.

To reduce your risk:

• Protect your SSN,

• Ensure your employer is protecting your SSN, and

• Be careful when choosing a tax preparer.

If your tax records are affected by identity theft and you receive a notice from the IRS, respond right away to the name and phone number printed on the IRS notice or letter.

If your tax records are not currently affected by identity theft but you think you are at risk due to a lost or stolen purse or wallet, questionable credit card activity or credit report, contact the IRS Identity Theft Hotline at 1-800-908-4490 or submit Form 14039.

For more information, see Publication 4535, Identity Theft Prevention and Victim Assistance.

Victims of identity theft who are experiencing economic harm or a system problem, or are seeking help in resolving tax problems that have not been resolved through normal channels, may be eligible for Taxpayer Advocate Service (TAS) assistance. You can reach TAS by calling the TAS toll-free case intake line at 1-877-777-4778 or TTY/TDD 1-800-829-4059.

Protect yourself from suspicious emails or phishing schemes. Phishing is the creation and use of email and websites designed to mimic legitimate business emails and websites. The most common act is sending an email to a user falsely claiming to be an established legitimate enterprise in an attempt to scam the user into surrendering private information that will be used for identity theft.

The IRS does not initiate contacts with taxpayers via emails. Also, the IRS does not request personal detailed information through email or ask taxpayers for the PIN numbers, passwords, or similar secret access information for their credit card, bank, or other financial accounts.

If you receive an unsolicited email claiming to be from the IRS, forward this message to [email protected]. You may also report misuse of the IRS name, logo, or other IRS property to the Treasury Inspector General for Tax Administration (TIGTA) at 1-800-366-4484. You can forward suspicious emails to the Federal Trade Commission at: [email protected] or contact them at www.ftc.gov/idtheft or 1-877-IDTHEFT (1-877-438-4338).

Visit IRS.gov to learn more about identity theft and how to reduce your risk.

Privacy Act NoticeSection 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons (including federal agencies) who are required to file information returns with the IRS to report interest, dividends, or certain other income paid to you; mortgage interest you paid; the acquisition or abandonment of secured property; the cancellation of debt; or contributions you made to an IRA, Archer MSA, or HSA. The person collecting this form uses the information on the form to file information returns with the IRS, reporting the above information. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and to cities, states, the District of Columbia, and U.S. commonwealths and possessions for use in administering their laws. The information also may be disclosed to other countries under a treaty, to federal and state agencies to enforce civil and criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. You must provide your TIN whether or not you are required to file a tax return. Under section 3406, payers must generally withhold a percentage of taxable interest, dividend, and certain other payments to a payee who does not give a TIN to the payer. Certain penalties may also apply for providing false or fraudulent information.

USCIS Form I-9

OMB No. 1615-0047 Expires 08/31/2019

Employment Eligibility Verification Department of Homeland Security

U.S. Citizenship and Immigration Services

Form I-9 11/14/2016 N Page 1 of 3

►START HERE: Read instructions carefully before completing this form. The instructions must be available, either in paper or electronically, during completion of this form. Employers are liable for errors in the completion of this form.

ANTI-DISCRIMINATION NOTICE: It is illegal to discriminate against work-authorized individuals. Employers CANNOT specify which document(s) an employee may present to establish employment authorization and identity. The refusal to hire or continue to employ an individual because the documentation presented has a future expiration date may also constitute illegal discrimination.

Section 1. Employee Information and Attestation (Employees must complete and sign Section 1 of Form I-9 no later than the first day of employment, but not before accepting a job offer.)Last Name (Family Name) First Name (Given Name) Middle Initial Other Last Names Used (if any)

Address (Street Number and Name) Apt. Number City or Town State ZIP Code

Date of Birth (mm/dd/yyyy) U.S. Social Security Number

- -

Employee's E-mail Address Employee's Telephone Number

I am aware that federal law provides for imprisonment and/or fines for false statements or use of false documents in connection with the completion of this form.

I attest, under penalty of perjury, that I am (check one of the following boxes):

1. A citizen of the United States

2. A noncitizen national of the United States (See instructions)

3. A lawful permanent resident

4. An alien authorized to work until (See instructions)

(expiration date, if applicable, mm/dd/yyyy):

(Alien Registration Number/USCIS Number):

Some aliens may write "N/A" in the expiration date field.

Aliens authorized to work must provide only one of the following document numbers to complete Form I-9: An Alien Registration Number/USCIS Number OR Form I-94 Admission Number OR Foreign Passport Number.

1. Alien Registration Number/USCIS Number:

2. Form I-94 Admission Number:

3. Foreign Passport Number:

Country of Issuance:

OR

OR

QR Code - Section 1 Do Not Write In This Space

Signature of Employee Today's Date (mm/dd/yyyy)

Preparer and/or Translator Certification (check one): I did not use a preparer or translator. A preparer(s) and/or translator(s) assisted the employee in completing Section 1.(Fields below must be completed and signed when preparers and/or translators assist an employee in completing Section 1.)I attest, under penalty of perjury, that I have assisted in the completion of Section 1 of this form and that to the best of my knowledge the information is true and correct.Signature of Preparer or Translator Today's Date (mm/dd/yyyy)

Last Name (Family Name) First Name (Given Name)

Address (Street Number and Name) City or Town State ZIP Code

Employer Completes Next Page

Form I-9 11/14/2016 N Page 2 of 3

USCIS Form I-9

OMB No. 1615-0047 Expires 08/31/2019

Employment Eligibility Verification Department of Homeland Security

U.S. Citizenship and Immigration Services

Section 2. Employer or Authorized Representative Review and Verification (Employers or their authorized representative must complete and sign Section 2 within 3 business days of the employee's first day of employment. You must physically examine one document from List A OR a combination of one document from List B and one document from List C as listed on the "Lists of Acceptable Documents.")

Last Name (Family Name) M.I.First Name (Given Name)Employee Info from Section 1 Citizenship/Immigration Status

List AIdentity and Employment Authorization Identity Employment Authorization

OR List B AND List C

Additional Information QR Code - Sections 2 & 3 Do Not Write In This Space

Document Title

Issuing Authority

Document Number

Expiration Date (if any)(mm/dd/yyyy)

Document Title

Issuing Authority

Document Number


Document Title

Issuing Authority

Document Number


Document Title

Issuing Authority

Document Number


Document Title

Issuing Authority

Document Number


Certification: I attest, under penalty of perjury, that (1) I have examined the document(s) presented by the above-named employee, (2) the above-listed document(s) appear to be genuine and to relate to the employee named, and (3) to the best of my knowledge the employee is authorized to work in the United States. The employee's first day of employment (mm/dd/yyyy): (See instructions for exemptions)

Signature of Employer or Authorized Representative Today's Date(mm/dd/yyyy) Title of Employer or Authorized Representative

Last Name of Employer or Authorized Representative First Name of Employer or Authorized Representative Employer's Business or Organization Name

Employer's Business or Organization Address (Street Number and Name) City or Town State ZIP Code

Section 3. Reverification and Rehires (To be completed and signed by employer or authorized representative.)A. New Name (if applicable)Last Name (Family Name) First Name (Given Name) Middle Initial

B. Date of Rehire (if applicable)Date (mm/dd/yyyy)

Document Title Document Number Expiration Date (if any) (mm/dd/yyyy)

C. If the employee's previous grant of employment authorization has expired, provide the information for the document or receipt that establishes continuing employment authorization in the space provided below.

I attest, under penalty of perjury, that to the best of my knowledge, this employee is authorized to work in the United States, and if the employee presented document(s), the document(s) I have examined appear to be genuine and to relate to the individual. Signature of Employer or Authorized Representative Today's Date (mm/dd/yyyy) Name of Employer or Authorized Representative

LISTS OF ACCEPTABLE DOCUMENTSAll documents must be UNEXPIRED

Employees may present one selection from List A or a combination of one selection from List B and one selection from List C.

LIST A

2. Permanent Resident Card or Alien Registration Receipt Card (Form I-551)

1. U.S. Passport or U.S. Passport Card

3. Foreign passport that contains a temporary I-551 stamp or temporary I-551 printed notation on a machine-readable immigrant visa

4. Employment Authorization Document that contains a photograph (Form I-766)

5. For a nonimmigrant alien authorized to work for a specific employer because of his or her status:

Documents that Establish Both Identity and

Employment Authorization

6. Passport from the Federated States of Micronesia (FSM) or the Republic of the Marshall Islands (RMI) with Form I-94 or Form I-94A indicating nonimmigrant admission under the Compact of Free Association Between the United States and the FSM or RMI

b. Form I-94 or Form I-94A that has the following:(1) The same name as the passport;

and(2) An endorsement of the alien's

nonimmigrant status as long as that period of endorsement has not yet expired and the proposed employment is not in conflict with any restrictions or limitations identified on the form.

a. Foreign passport; and

For persons under age 18 who are unable to present a document

listed above:

1. Driver's license or ID card issued by a State or outlying possession of the United States provided it contains a photograph or information such as name, date of birth, gender, height, eye color, and address

9. Driver's license issued by a Canadian government authority

3. School ID card with a photograph

6. Military dependent's ID card

7. U.S. Coast Guard Merchant Mariner Card

8. Native American tribal document

10. School record or report card

11. Clinic, doctor, or hospital record

12. Day-care or nursery school record

2. ID card issued by federal, state or local government agencies or entities, provided it contains a photograph or information such as name, date of birth, gender, height, eye color, and address

4. Voter's registration card

5. U.S. Military card or draft record

Documents that Establish Identity

LIST B

OR AND

LIST C

8. Employment authorization document issued by the Department of Homeland Security

1. A Social Security Account Number card, unless the card includes one of the following restrictions:

2. Certification of Birth Abroad issued by the Department of State (Form FS-545)

3. Certification of Report of Birth issued by the Department of State (Form DS-1350)

4. Original or certified copy of birth certificate issued by a State, county, municipal authority, or territory of the United States bearing an official seal

5. Native American tribal document

7. Identification Card for Use of Resident Citizen in the United States (Form I-179)

Documents that Establish Employment Authorization

6. U.S. Citizen ID Card (Form I-197)

(2) VALID FOR WORK ONLY WITH INS AUTHORIZATION

(3) VALID FOR WORK ONLY WITH DHS AUTHORIZATION

(1) NOT VALID FOR EMPLOYMENT

Page 3 of 3Form I-9 11/14/2016 N

Examples of many of these documents appear in Part 8 of the Handbook for Employers (M-274).

Refer to the instructions for more information about acceptable receipts.

Addendum to Keller Williams West Ventura County Independent Contractor Agreement

BROKER'S OBLIGATIONS AND LIMITATIONS Broker may delegate any or all of Broker's responsibilities under this agreement to a specified agent or manager. This person must have at least two (2) years’ full-time experience as a licensee. Broker agrees to assist Licensee with advice, instruction and advertising support. All advertising shall be approved and placed by Broker. Broker agrees to provide Licensee with the use, equally with other Licensees, of all the facilities of the offices operated by Broker in connection with the subject matter of this contract. Broker will supervise and manage the activities of the Licensee as required by the CA Bureau of Real Estate and will review the files and transactions of the Licensee for compliance with Commissioner’s Regulations and state and federal laws. The review may, at the instruction of the Broker, be conducted by a licensee who is either a Broker-Associate or a Salesperson with at least two (2) years’ full-time experience as a licensee. Broker may reject any transaction deemed unsatisfactory. Broker shall not be liable to Licensee for any expenses incurred by Licensee or for any of Licensee's acts except as specifically required by law, nor shall Licensee be liable to Broker for office help or expenses. Document Requirement:

x Every file must contain a copy of zipForms+ Cover Sheet identifying all the parties x All licensees must use ZipForms+ to comply with existing statutes and court decisions x A licensee must not practice Law x Every transaction file must be available to CalBRE if requested

Broker: ___________________________________________________ Date: __________________ Licensee: _________________________________________________ Date: __________________

City Business LicensesA business license is an annual tax you pay for doing business within a city boundary. It is required BEFORE any business, trade, profession, enterprise, establishment, occupation, or calling is conducted within the boundaries of a city, even if your business is physically located outside the city limits or you have a business license from another city. Business license fees and regulations are different for each city.

Contact your city for further information:CAMARILLO: 601 Carmen Drive (805) 388-5330FILLMORE: 250 Central Avenue (805) 524-3701MOORPARK: 799 Moorpark Avenue (805) 517-6200OJAI: 401 South Ventura Street (805) 646-5581OXNARD: 214 S. C Street, Oxnard (805) 385-7817PORT HUENEME: 250 North Ventura Road (805) 986-6526SANTA PAULA: 970 Ventura Street (805) 933-4211SIMI VALLEY: 2929 Tapo Canyon Road (805) 583-6736THOUSAND OAKS: 2100 East Thousand Oaks Boulevard (805) 449-2201VENTURA: 501 Poli Street, Room 107 (805) 658-4715

County of VenturaIf you regularly transact business in this state for profit under a fictitious business name, you will need to file a Fictitious Business Name Statement with the County Clerk’s Office. County Government Center, 800 South Victoria Avenue, Ventura, CA 93003

Business License Requirements

www.kwwestventuracounty.com2831 N. Ventura Rd.Oxnard, CA 93036Oxnard. Camarillo. Ojai. Ventura.

Nancy AmorteguyTeam Leader, Broker of Recordcell. 805.844.6466email. [email protected]