- Use this form to notify the Commission that you wish to terminate your affiliation with a firm or sole proprietorship.
- IMPORTANT NOTE: If you are a broker-in-charge, this action will affect all licensees currently under your supervision at this office.
Please Note: Before a Broker-in-Charge is removed, a new properly completed Broker-in-Charge Declaration Form (REC 2.04)
should be submitted to the Commission. Otherwise, when a Broker-in-Charge is removed from a firm or sole proprietorship, all
licensees affiliated with that Broker-in-Charge will be affected. Provisional brokers will be placed on Inactive Status. “Full” brokers
will remain on Active status at their home addresses but will no longer be affiliated with the firm/sole proprietorship.
Please allow 3-5 business days for your request to be processed. You will receive a Notice of License Record Change acknowledging the
requested change. If you do not receive a Notice within 30 days, please contact the Commission’s Education and Licensing Division.
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.