Date *

Organization *

Please fill out your brokerage name.

Address Line 1 *

Address Line 2

City *

State *

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Postal Code *

Phone *

Local Board of REALTORS® *

Financial Institution Name *

Financial Institution Address Line 1 *

Financial Institution Address Line 2

Financial Institution Address City *

Financial Institution Address State *

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Financial Institution Address Postal Code *

Financial Institution Phone Number *

Account Title *

Principal Broker First Name *

Principal Broker Last Name *

Principal Broker Email *

UARHOF Participating Broker *

By clicking this box, I certify that the above-named real estate brokerage has a trust account with the above-named financial institution that is an interest-bearing account with the Utah Association of REALTORS® Housing Opportunity Fund as the interest beneficiary. The brokerage agrees to maintain this interest-bearing account for the benefit of UARHOF and agrees to provide notice to the Utah Association of REALTORS® should the firm close the interest-bearing trust account. I understand that UARHOF is the beneficiary of only the earned interest and that all deposits with this account remain the property of those parties to the real estate transaction for which the funds are placed in trust.