COMPANY/BRANCH CHANGE OF NAME AND/OR ADDRESS FORM
Complete this form online and print it for submission OR print the form and complete it in black or blue ink.
Submit $50 to cover the new licenses for the company and qualifying broker plus an additional $25 for ea
ch licensed person registered
under the company or branch. (EXAMPLE: Company and qualifying broker + 1 associate broker + 2 salespersons = $50 + $25 + $50 for
total fee of $125).
Make fees payable to the Alabama Real Estate Commission and mail, with form, to the Alabama Real Estate Commission, 1201
Carmichael Way, Montgomery, AL 36106 by certified or registered mail.
Complete forms are normally processed within 3 business days. Once processed, the new licenses will be available for
printing by the Qualifying Broker from the Commission’s website, arec.alabama.gov, under the broker’s login.
Pursuant to Section 790‐X‐3.01 of the Alabama Real Estate License Law, the Company/Branch named below hereby submits the
following names and/or address change:
Check One: Change Company Name Change Company Address Change Both
I.
OLD INFORMATION
Company/Branch License Number
Company and/or Branch Name (if applicable)
II.
NEW INFORMATION
Company and/or Branch Name (if applicable)
Physical Address
City
Physical Address
City
State Zip State Zip
Mailing Address
City
Mailing Address
City
State Zip State Zip
III.
CURRENT COMPANY INFORMATION
Telephone Number
Fax Number
IV.
CURRENT QUALIFYING BROKER INFORMATION
Home Address
City
Email State Zip
Website Email
Responsibility is hereby accepted for the actions covered by the Alabama Real Estate License Law of any and all salesperson and
associate brokers whose licenses are issued to the company.
Print Name of Qualify Broker
Signature of Qualifying Broker Date
The signature of the Qualifying Broker for the main company is required if changes are being made to a branch office.
REVISED 12.05.2017
