612 South Summit Street Little Rock, AR 72201 501.683.8010
Please furnish the following information to the Arkansas Real Estate Commission as required by
Arkansas Code Ann. §18-14-202 (b), (c) (d) & (f).
THE RENEWAL APPLICATION IS FOR:
Acquisition Agent Broker Managing Agent Exchange Agent
1. Applicant’s Company Name: ________________________________________________
2. Address: ________________________________________________________________
(Street / PO Box)
_______________________________________________________________________
(City) (State) (Zip Code)
3. Telephone Number: _______________________________________________________
4. Email Address:___________________________________________________________
5. Name and Title of responsible Managing Employee or Contact:
_______________________________________________________________________
6. Name(s) of Time-Share Plan(s) Offered:
_______________________________________________________________________
7. Have you furnished the Bond(s) as required by Arkansas Code Ann. §18-14-202?
(Not applicable to Exchange Agents)
YES NO
Are the Bond(s) previously furnished in force?
YES NO
8. Is there any other information which is necessary to reflect a material change from the
previous registration?
YES NO
If yes, please attach information and explain.
