612 South Summit Street Little Rock, AR 72201-4701 501.683.8010
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Arkansas Real Estate Commission
Arkansas Time-Share Law of 1983
Application for Registration of Acquisition Agents, Brokers,
Managing Agents and Exchange Agents of Time-Share Plans
ATTACH ADDITIONAL SHEETS IF NECESSARY.
1. Is the applicant: Acquisition Agent Broker Managing Agent Exchange Agent
2. Full name of applicant:_____________________________________________________________________
3. Office Address:___________________________________________________________________________
_______________________________________________________________________________________
City State Zip Code
Telephone: ( )______________________________________________________________________
Email Address:___________________________________________________________________________
4. A. Business organization: _________________________________________________________________
(State whether individual, corporation, partnership, association, or other)
B. If a corporation, state:
(1) State of incorporation:
______________________________________________________________________
(2) Date of incorporation:
______________________________________________________________________
(3) Trade name:
_______________________________________________________________________
(4) Name and address of Arkansas resident agent:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
(5) List the name and address of each officer and director:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
C. If a partnership or other than an individual or corporation, state:
(1) Trade name:_____________________________________________________________
(2) Year of formation:_________________________________________________________
