Unlock hundreds more features
Save your Form to the Dashboard
View and Export Results
Use AI to Create Forms and Analyse Results

Sign UpLogin With Facebook
Sign UpLogin With Google

Commission Disbursement Authorization Form Template

Streamline Your Commission Payments Effortlessly

Struggling to manage commission payments can lead to frustration and delays. This Commission Disbursement Authorization Form Template is designed for businesses and agents who want to simplify the process of directing commission payments to third parties. By using this template, you can ensure timely payments, maintain precise records, and reduce the risk of errors, while also providing a professional look to your requests. Plus, with WCAG-aligned labels, you'll remain compliant with accessibility standards. Try out the live template today!

Full legal name
Company or agency name
Email
Phone
Mailing address (if check is selected)
Commission amount or percentage to disburse
Preferred disbursement frequency
One-time
Per sale or transaction
Weekly
Biweekly
Monthly
Quarterly
Annually
As accrued
Other
Please Specify:
Reference or memo (optional)
Disbursement currency
USD
EUR
GBP
CAD
AUD
Other
Please Specify:
Account holder name (as it appears on the account)
Bank name
Account number or IBAN
Routing number or SWIFT/BIC
Preferred payment method
ACH or EFT
Wire transfer
Check
PayPal
Other
Please Specify:
I authorize the company to disburse commissions to the account specified above
Strongly disagree
Disagree
Neither
Agree
Strongly agree
I acknowledge that erroneous credits may be reversed and corrected
Strongly disagree
Disagree
Neither
Agree
Strongly agree
Is a current tax form (e.g., W-9 or W-8) on file?
Yes
No
Effective date of this authorization
Permit the company to retain banking details for future disbursements
Yes
No
Typed signature of payee
Signature date
Notes or special instructions (optional)
I certify that the information provided is true and complete
Strongly disagree
Disagree
Neither
Agree
Strongly agree
{"name":"Full legal name", "url":"https://www.quiz-maker.com/QPREVIEW","txt":"Full legal name, Company or agency name, Email","img":"https://www.quiz-maker.com/3012/images/ogquiz.png"}
Paper art illustration depicting a commission disbursement authorization form for FormCreatorAI article

When to use this form

Use this template when you need written approval to release commissions from a sale or referral. Brokers, team leads, escrow staff, and accounting use it to spell out who gets paid, how much, and when. It is ideal for real estate closings, where you must direct title to split funds between an agent, brokerage, and a referral partner. It also fits affiliate or marketplace payouts with multiple recipients and deductions. Add proof of settlement or attach a Payment confirmation form so finance can verify the amounts. If you will charge a card for fees or recover advances, include a Stripe payment form. Clear instructions here speed closing day and reduce rework, disputes, and delays.

Must Ask Commission Disbursement Authorization Questions

  1. What transaction is this payout for (property address, deal ID, or closing file number)?

    This ties the disbursement to a single deal so funds are never misapplied. You improve reconciliation with your ledger and closing documents.

  2. Who are the payees, their roles, and the exact amounts or percentages for each?

    Listing recipients and splits up front prevents math errors and missed parties. You also align with IC agreements and reduce post-closing disputes.

  3. How should each payee be paid (ACH, wire, or check), and what payment details are required?

    Choosing the method now avoids delays and returned transfers. If paying by check, pair this with the Accounts payable check request form so finance has everything to issue it.

  4. What deductions or holds should we take before paying out (brokerage fee, franchise fee, E&O, referral, TC), and for how much?

    Capturing deductions upfront prevents overpayment and later clawbacks. You create a clear audit trail for fees and compliance.

  5. Who is authorizing this disbursement, and which supporting documents are attached (contract, invoice, closing disclosure)?

    Named approval shows accountability and gives finance the green light to release funds. Supporting docs help you verify amounts before sending money.

More Forms

Copy/Edit Form Send to Recipients Make a Form w/AI Form Builder Must Ask Questions
  • 100% Free - No Catches
  • Collect Responses Today
  • Tailor to your Look & Feel