Change in Qualifying Broker Form

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  1. This is NOT the Request for BIC Eligible Status and-or Broker-In-Charge Designation form. To designate a Broker-in-Charge, go to Request for BIC Eligible Status and-or Broker-In-Charge Designation (REC 2.25).
  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


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