229 Peachtree Street NE
Atlanta, GA 30303-1605
Phone: 404-656-3916
Fax: 404-656-6650
International Tower, Suite 1000
GREC Trust Account (07-2013)
Page 1 of 2
Georgia Real Estate Commission
Georgia Real Estate Appraisers Board
Email: grecmail@grec.state.ga.us
www.grec.state.ga.us
This form may be used to: (1) Add new Trust Accounts to a Firm record, (2) Remove existing Trust Accounts from a Firm record, (3)
Change the account number of a Trust Account already registered with GREC, (4) Change the bank name of a Trust Account
already registered with GREC.
New accounts should be registered with the Commission within one month of opening. Any account not registered within one
month requires a $25.00 fee. The adding and removing of Trust Accounts may also be done online, by logging into the Firm record.
(If updated online, this form is not required.)
FOR OFFICE USE ONLY
Section A
Firm Info
rmation
Trust Account Registration Form
Firm License #
LIC#
INV
CodesProc By & Proc Dt
Fee
Rec By
Rec Dt
Register Trust Account
Section B
Effective Date
Account #
Licensee Name
Institution Name
Licensee Signature
I hereby certify the information provided in this application is true to the best of my knowledge and belief.
I hereby authorize the Commission to examine any of the firm’s real estate escrow / trust accounts at such times as it may direct. I
certify that the above referenced account(s) are federally insured and are or use for only the deposit of the funds of others in real
estate brokerage transactions, as required by law.
I hereby approve the above mentioned account as permitted by O.C.G.A. §43-40-20.
Date
Broker Signature
License Number
Date
*Affiliated Licensees may open and maintain Trust Accounts only for properties owned by the Licensee with the
permission of the Broker holding Licensee's license. (See Chapter 520-1-.08) If this account is to be used
exclusively by a Licensee, provide the name and license number below:
Section D
Broker Approval to Add
Account
Affiliated Licensee Information
Section C
Firm Name:
Type of Trust Account:
Firm Email:
Firm (Skip to Section D)
Affiliated Licensee* (Complete Sections C & D)
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229 Peachtree Street NE
Atlanta, GA 30303-1605
Phone: 404-656-3916
Fax: 404-656-6650
International Tower, Suite 1000
GREC Trust Account (07-2013)
Page 2 of 2
Georgia Real Estate Commission
Georgia Real Estate Appraisers Board
Email: grecmail@grec.state.ga.us
www.grec.state.ga.us
Remove Trust Account
Section E
Institution Name
Account #
Effective Date
If this account was registered as an Affiliate Account, to be used exclusively by a Licensee, provide the
Licensee's name and license number below:
Licensee Name
License Number
Broker Approval to Remove Trust Account
Section F
Broker Signature
Date
I hereby authorize the removal of the above mentioned account as permitted by O.C.G.A. §43-40-20 (f) & (h).
Bank Name or Account # Change
Section G
Broker Signature
Date
I hereby authorize the above changes to our Firm Trust Accounts as required by O.C.G.A. §43-40-20.
New Bank Name
Previous Bank Name
Account #
Previous Account #
New Account #Bank Name
Use this section to list any changes to existing Trust Accounts that have been previously registered with GREC, for which
either the Bank Name or Account Number has been changed.
Bank Name Change:
Account Number Change:
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