REE-043-10
Rev. 07/2020
IREC use only
License #:
__________________________
Approved:
__________________________
575 E. Parkcenter Blvd., Suite 180
Boise, Idaho 83706
Offi ce: (208) 334-3285
Fax: (208) 334-2050
licensing@irec.idaho.gov
irec.idaho.gov
NOTICE OF BROKER
CHANGE
1. LICENSED BROKERAGE NAME:
________________________________________________________________________________________________________
Company Name License No.
Brokerage is a (choose one):
Corporation Limited Liability Company Limited Partnership Limited Liability Partnership Branch Offi ce
2. NEW DESIGNATED BROKER/BRANCH OFFICE MANAGER:
New DB/BOM Name: _______________________________________________________________________________________
Does the new DB/BOM already have an Idaho broker license?
No - Attach a completed broker license application for the new DB/BOM
Yes - Provide Idaho broker license number __________________________________
I have completed the Idaho Business Conduct & Offi ce Operations* or Brokerage Management* course within the 3
years immediately preceding the date of this application (inactive to active DB or AB to DB applicants only). *Must
attach a copy of the completion certifi cate if it’s not noted on your IREC education record.
3. ERRORS & OMISSIONS INSURANCE COVERAGE FOR THE NEW DB/BOM: (E&O insurance must have an eff ective date on or
before the date you submit this request.)
Rice Insurance Services Company (Commission group policy - attach copy of RISC certifi cate of coverage) - OR
Independent Coverage (attach completed, signed Certifi cation of E&O Coverage form (REE-141 or REE-142) showing coverage
for the DB/BOM)
REQUIRED ATTACHMENTS
____ Broker license application for new DB/BOM (if not already licensed as a broker in Idaho)...........................................................
____ Documentation of the DB change for your brokerage (choose the applicable entity type) (not required for BOM
changes):
Corporation:
____ Corporate resolution showing the DB is an offi cer and has been named DB for the corporation...........................
AND
____ List of names, titles and addresses of all offi cers and directors.............................................................................
Limited Liability Company:
____ Operating agreement showing the DB is a member or manager and has been named DB for
the LLC...................................................................................................................................................................
AND
____ List of names, titles and addresses of all members and managers........................................................................
Limited Partnership or Limited Liability Partnership:
____ Partnership agreement showing the DB is a general partner and has been named DB for the
LP or LLP................................................................................................................................................................
AND
____ List of names, titles and addresses of all partners..................................................................................................
____ E&O insurance certifi cate of coverage for the new DB/BOM.......................................................................................................
____ I have completed the BCOO or Brokerage Management course within the previous 3 years (inactive to active
DB or AB to DB applicants only)...................................................................................................................................................
__________________________________________________ ________________________________ __________________
Current DB Signature Title Date
__________________________________________________ ________________________________ __________________
Current BOM Signature (if applicable) Title Date
IREC use
ONLY
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