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Referral Acknowledgement Form


As an IRC referral agent, use this form when you select an agent and agency to service your client — and you prefer to negotiate the referral fee yourself. All referral agreements must be in writing and signed by all parties on the form.


Send a copy of the signed Referral Acknowledgement Form to IRC and there will be no delays in getting your commission check to you, because we know how to process the check from the selected agency.


Call IRC at 1-800-472-4620 if you have any questions about this process.