Seller and Originator Registration Fields marked with * are mandatory. Seller or Broker Information: Broker or Property Owner Name or Company*: Entity Type*(e.g. Individual, Corp, LLC, etc.):IndividualCompany Contact Person*: Property Type:ResidentialCommercial Address Line 1: Address Line 2: City: State: Zip Code: Business Phone*: Mobile Phone: Email*: Wireless Lease and Site Information: Number of Sites with Cell Towers or Rooftop Installations(that the property owner is receiving rent from): Main or Representative Cell Site Property Address:Same As Above Address Line 1: Address Line 2: City: State: Zip Code: Name: Phone: Email: What type of installation(s) do you currently have on your property?:Cell TowerRooftop InstallationMultiple Sites/Types owned Number of Tenants making payments to you: Is there a mortgage or other lien or loan secured by the property?:YesNo Wireless Lease Tenant Information: (if more than one tenant, please enter total amount of rent received and contact us via phone or email and so that we can take down your information) Name of Tenant (e.g. AT&T, T-Mobile, Verizon, Sprint, etc. Enter Multiple if more than one): Original Commencement Date of Lease (Enter Multiple if more than one lease or site): Amount of Rent Currently Received(Enter total if more than one lease or site): Frequency of Payment:MonthlyQuarterlySemi-AnnuallyAnnuallyVarious Escalation/Scheduled Rent Increase Percentage or dollar amount:%$Various Escalation Timing:AnnuallyEvery 5 yearsOtherVarious Next Anticipated Escalation Date: Have you received any termination notice for this site from your tenant?:YesNo By checking the box, you acknowledge having read the terms and conditions given below. Terms and Conditions: The information you enter above for the registration of a site or an option to purchase a site will be kept confidential by TCA. You, as a registrant, agree and understand that values, assessments, commission estimates and other information provided by TCA to you as a result of your registration are also confidential and are estimates only. Additionally, you certify that you are the landlord and payee for the lease/site listed above, his/her authorized representative or that you are an originator or broker interested in becoming a rep for TCA. You also certify that you have read and agree to the Terms and Conditions of Use and Legal Disclaimer published by TowerCapAdvisors.com. Finally, you hereby release and hold harmless Tower Capital Advisors, LLC, its agents and personnel with respect to all liability, loss, damages, claims, suits, causes of action, or expenses of any kind or nature, including, but not limited to, legal fees and costs arising out of our having provided this information. **TCA reserves the right to approve or deny any and all sellers, brokers or originators in our sole discretion. If you are provided access to our private registration section, you agree to keep your user account name, password and login information confidential.