Temporary Broker License Checklist Form LI-240/rev 8/19
CHECKLIST FOR TEMPORARY BROKER LICENSE FORM
DO NOT SUBMIT THIS APPLICATION BY FAX OR E-MAIL
To submit packet:
• Submit Temporary Broker License Form and $50 filing fee.
it Disciplinary Actions Disclosure Form (LI-214/LI-244).
you are an unlicensed individual, also complete and submit Licensee’s Personal Information Form (LI-235).
it a letter advising the Department of the broker’s illness, disability, or death. If broker is deceased, you must
provide a copy of the death certificate, or newspaper obituary.
• Submit a letter from the surviving spouse, attorney representing the broker/family, personal representative, or other
responsible party appointing an individual to serve as a temporary broker.
• A s
alesperson or associate broker who is appointed as Temporary Broker must submit a severance from the prior
employing broker or be administratively severed.
n issued, license is valid for up to 90 days except, under “B”, additional time may be granted not to exceed 15
months. Should additional time beyond 90 days be required, the temporary broker must submit a written request to
the Department at least two weeks prior to the expiration date of the temporary broker’s license.
NO MORE THAN ONE TEMPORARY BROKERS LICENSE WILL BE ISSUED
Pursuant to A.R.S. § 32-2133 and A.A.C. R4-28-305;
he Commissioner may issue a temporary license as a broker to a licensed or unlicensed person for the purpose of winding
up the existing or pending business of a licensed broker in the following cases:
1. To the
surviving spouse, next of kin, the administrator or personal representative, or an employee of the
administrator or personal representative of a deceased licensed broker.
2. To t
he spouse, next of kin, employee, legal guardian or conservator of a licensed broker disabled by sickness, injury
B. Each temporary license is for a period of not over 90 days and shall not be extended for a longer period, except that a
license issued to an administrator or personal representative or the employee of the administrator or personal
representative continues until the personal representative or administrator disposes of the deceased broker’s business, but
not to exceed a period of 15 months.
ve time—take a moment to review your application and make sure you have signed it where required and have attached
supporting documents and the required fee before you submit to the Department. If the Department receives an incomplete
application, we will return the application to you unprocessed.
N EQUAL EMPLOYMENT OPPORTUNITY AGENCY”
is form is available in alternate formats by contacting the Operations Office at 602-771-7760 or
by email at www.azre.gov
through the Message Center