Change in Qualifying Broker Form


An image of the North Carolin Real Estate Seal.

  1. This is NOT the Broker-in-Charge Declaration form. To designate a Broker-in-Charge, go to REC 2.04 Broker-in-Charge Declaration.
  2. Prior to completing this form, please read the Qualifying Broker Responsibilities.
  3. The original designation of a Qualifying Broker of a business entity (firm) is made with the original firm application. This form is to be used only for a change in the Qualifying Broker.
  4. The Qualifying Broker is required to possess an active North Carolina Real Estate Broker License and must be a corporate officer if the firm is a corporation, a general partner if a partnership, or a manager if a limited liability company.
  5. The Qualifying Broker acts as the primary contact person between the firm and the Real Estate Commission and performs certain administrative duties (Page 2 of this form).
  6. Only one Qualifying Broker is permitted at any time for a particular firm, even if the firm operates multiple real estate offices.

Qualifying Broker Details

Firm Details

Contact Details

Signature and Certification

I certify to the North Carolina Real Estate Commission that I am a officer/manager/general partner of the real estate firm shown herein and duly designated to serve as Qualifying Broker for such firm. I further certify that I will carry out my responsibilities as Qualifying Broker for such firm in accordance with Commission rules and that I will continually maintain my license on Active Status.

(Type your name)

Date Signed

12/18/2017


Info
An image of an exclamation point.
Info
Processing Form...
107.20.115.174

This form is not meant to be printed. If you have already completed the form please use the submit button at the bottom to send the form directly to the Commission.