Fillable Agent/adjuster name or address change request (Texas Real Estate Contracts)

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Agent/adjuster name or address change request (Texas Real Estate Contracts)

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The Agent/adjuster name or address change request (Texas Real Estate Contracts) form is 2 pages long and contains:

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  • 29 other fields

Country of origin: US
File type: PDF

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The Texas Real Estate Commission (TREC) is an agency that governs real estate practices in the state of Texas USA. I its headquarters are located in Ausin Texas at 1700 North Congress.

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FIN533 | 0421
Agent/adjuster name or address change request
You must fill out and send us this form within 30 days of a change to your name or address.
Notes: If you’ve moved from Texas to another state, contact the department of insurance in your
new state before submitting this form. You must have a license in your new state of residence
before we can change your Texas license to a nonresident license.
If you’re a licensed agent or adjuster in another state who has moved to Texas, you must fill out
form FIN594.
TDI license number
First name Middle name Last name Suffix
► Fill out this section if you changed your name:
New legal name
First name Middle name Last name Suffix
Attach a copy of an official document showing that your name changed. For example, send a
copy of a marriage certificate or divorce decree.
► Fill out all parts of this section if your address changed:
Phone numbers
Personal ( )
Business ( )
Email addresses
Personal
Business
Texas Department of Insurance
2/2
FIN533 | 0421
Business address
Street address ________________________________
City
Mailing address
State _ ZIP
Street address or P.O. Box
City State _ ZIP
A P.O. Box will be accepted only for a mailing address.
Resident address
Street address
City State _ ZIP
Attach a copy of a Letter of Certification from your resident state.
► Sign here:
The answers I gave on this form are true and correct:
Licensee signature Date
Print name
► Contact us if you have questions:
You can: (1) email License@tdi.texas.gov, or (2) call 512-676-6500.
► Know your rights:
You can request information we have about you by emailing OpenRecords@tdi.texas.gov or writing
to: Public Information Coordinator, Texas Department of Insurance, PO Box 12030 (mail code GC-
ORO) Austin, Texas 78711-2030. You also have the right to ask that we fix information we have
about you that is wrong. To ask for a correction, send (1) your name, mailing address, and your
phone number, (2) details about what needs to be fixed, and (3) the reason or proof showing why
the information is wrong. Send this by email to RecordCorrections@tdi.texas.gov or by mail to:
Record Correction Request, Texas Department of Insurance, PO Box 12030 (mail code CO-AAL-CC),
Austin, Texas 78711-2030.
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Agentadjuster name or address change request (Texas Real Estate Contracts)

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Completed 3 May 2022

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