REE-149-22 Rev. 07/2020 Page 2 of 2
4. ERRORS & OMISSIONS INSURANCE: (E&O insurance must have an eective date on or before the date you
submit your application)
Rice Insurance Services Company (Commission group policy - attach copies of separate RISC certicates of
coverage - 1 for the DB and 1 for the partnership) - OR
Independent Coverage (attach completed, signed Certication of E&O Coverage form(s) (REE-141 and/or REE-
142) showing coverage for both the DB and the partnership)
REQUIRED ATTACHMENTS
____ $50licensefee(checkorcreditcardauthorizationform) ...........................................................................................................
____ List of partners(names,titlesandaddressesofallpartnersofthepartnership)..........................................................................
____ PartnershipRegistration(attachthele-stampedcopyofeithertheStatement of Qualication of Partnership or
Statement of Foreign Qualication(ifaforeignpartnership)issuedbytheIdahoSecretaryofState).........................................
____ DBARegistration(ifapplicable,attachale-stampedcopyofaCerticate of Assumed Business Name issued
bytheIdahoSecretaryofState)...................................................................................................................................................
____ Partnership Agreement stating that the proposed DB has full authority to act on behalf of the company, is a
general partner, and has been named the Designated Broker for the company..........................................................................
____ TrustAccountNoticationForm(REE-088)whetheryouwillholdentrustedfundsornot............................................................
____ E&OInsuranceCerticationofCoverageformforboththeDBandthecompany(part4)..........................................................
____ BrokerLicenseApplicationforproposedDB(ifnotalreadylicensedasanIdahobroker)...........................................................
____CompletioncerticateforBCOOorBrokerageManagementcoursewithintheprevious3years(inactivetoactive
DBorABtoDBapplicantsonly).........................................................................................................................................................
Proposed Designated Broker (signature)
NOTARY IS REQUIRED
State of )
)ss.
County of )
I, , a notary public, do hereby certify that on this day
of , 20 ,
personallyappearedbeforemewho,beingbymerstdulysworn,declaredthathe/sheistheproposeddesignatedbrokerandapartner
of the partnership, that he/she signed the foregoing document on
behalf of the partnership, and that the statements therein contained are true.
__________________________________________________
Notary Public
notary
seal __________________________________________________
My Commission Expires
NOTICE: Because of rising costs associated with issuing a refund, it is the policy of IREC to refund overpayments of under $25 only if requested in writing
within 30 days of IREC receipt of the overpayment. Overpayments of $25 or more will be automatically refunded. There is a $20 fee assessed for each
check returned to IREC for insucient funds.
IREC use
ONLY