Fillable Real Estate License - Transfer Form printable pdf download

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Arkansas Real Estate Commission

501 683-8010 FAX: 501 683-8020

REAL ESTATE LICENSE - TRANSFER FORM

Instructions: To transfer, complete all parts of the form. Submit $30 transfer fee.

Terminating principal broker is responsible for signing and returning license and pocket card

PART I - Terminating Principal, Executive or Designated Executive Broker completes

PART II - Transferring Licensee completes

PART III - New Principal, Executive, or Designated Executive Broker completes

PART I:

Licensees Name: ___________________________________________________________________________________

(First Name)

(Middle Name or Initial)

(Last Name)

License Number: _______________________________ Type of License ______________________________________

Effective Date: _______________________, this license is no longer associated with _____________________________

______________________________________________

_______________________________________________

Terminating Principal Broker (Please Print)

Signature of Terminating Principal Broker

PART II:

I hereby certify that I am not taking, and will not take, any listings, management contracts, appraisals, lease agreements,

or copies of any such documents, or any other pertinent information belonging to the former principal broker or firm.

Signature of Licensee: _______________________________________________________________________________

Home Address: _____________________________________________________________________________________

City: _____________________________________________ State: ______________ Zip: ________________________

Home Phone: _________________________ Email Address: ________________________________________________

PART III:

I accept the responsibility for the actions of the above licensee and give consent for licensee to be licensed with the Firm

below as: ____ Designated Executive Broker ____ Executive Broker ____ Associate Broker ____ Salesperson

(Separate form needed)

Firm Name: _______________________________________________________________________________________

Firm Address: _______________________________________________ Firm PO Box: __________________________

Firm City: ________________________________________ Firm State: _____________ Firm Zip: _________________

Firm Phone Number (with area code): ___________________________________________________________________

*PB, EB or DEB License #: ______________________________________

COMMISSION USE ONLY

____________________________________________ / ________________

Receipt # ____________________________

*PB, EB or DEB Signature

Activation Date

*(For transferring a license, a signature and license number is required.)

NOTICE: This form must be mailed or delivered to AREC immediately to serve as a temporary license. The

temporary license will be valid for only thirty (30) days from the date it was mailed or delivered to AREC, with the new

principal broker’s original signature, and ONLY

when AREC has received notice of licensees’ termination by previous

principal broker.

Return to: AREC 612 South Summit St. Little Rock, AR 72201

REV (02/2013)

Real Estate License - Transfer Form

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