Fillable NOTICE OF NAME CHANGE INSTRUCTIONS: Complete this form (Idaho Real Estate Commission)

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NOTICE OF NAME CHANGE INSTRUCTIONS: Complete this form (Idaho Real Estate Commission)

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REE-042-09
Rev. 07/2020
IREC use only
License #:
__________________________
Approved:
__________________________
NOTICE OF
NAME CHANGE
_______________________________________________________________________ _______________
Authorized signature Date
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
INSTRUCTIONS: Complete this form and submit with legal documentation of the name
change as specifi ed below. Your change request will not be processed without supporting documentation.
Name of Licensee OR Entity for Which Name Change is Requested:
_____________________________________________________________________ ________________
Name as it now appears on the license License No.
1. Personal Name Change: You must enclose one (1) item from EACH list.
Full New Legal Name: _____________________________________________________________________
(must exactly match the full name listed on your legal ID)
3. Company or DBA name: Include a fi le-stamped copy of the DBA registration or other name change
document from the Idaho Secretary of State (https://sos.idaho.gov/).
New DBA or Company Name: ______________________________________________________________
To change the type of business entity (i.e., LLC to Corporation), do not use this form. Instead, you must
submit a new license application for the new entity.
List A** List B
(**must show your full new legal name)
Idaho driver’s license or ID card and Certifi ed copy of marriage license
Valid drivers license or ID card from another Certifi ed copy of court order for name
state or US territory change
Valid US Passport Certifi ed copy of divorce decree
US Military ID or Military Dependant’s ID
US Coast Guard Merchant Mariner ID
Native American tribal document
2. Add Nickname: The nickname must be a valid nickname or derivative of your legal name.
Nickname: ______________________________________________________________________________
(i.e, Tom for Thomas, Kim for Kimberly, etc.)
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NOTICE OF NAME CHANGE INSTRUCTIONS: Complete this form (Idaho Real Estate Commission)

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Completed 28 December 2021

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