Application For Branch Office License Form 2000 printable pdf download

Application For Branch Office License Form 2000

03/00

WYOMING REAL ESTATE COMMISSION

2020 CAREY AVENUE, SUITE 100

CHEYENNE, WYOMING 82002-0180

(307) 777-7141

APPLICATION FOR BRANCH OFFICE LICENSE

In compliance with Section 33-28-109, Wyoming Statutes 1977, as amended, and in compliance with the Wyoming

Real Estate Commission’s Rules and Regulations, I hereby make application for a branch office license.

Name of Responsible Broker: ____________________________________________________________

I am presently licensed as ( ) an individual proprietorship; ( ) the responsible broker for a corporation;

( ) the responsible broker for a partnership; ( ) or the responsible broker for an LLC.

Name of corporation, LLC, partnership or trade name: ___________________________________________

I request that a branch office license be issued at the following address:

_______________________________________________________________________________________

Street

City

State

Zip Code

_______________________________________________________________________________________

Branch Office Telephone

Fax

E-Mail

I am aware that every branch office must be supervised by an associate broker who resides in the community

in which the branch office is located.

Name of designated associate broker: _________________________________________________________

The branch office complies with local zoning regulations.

( ) Yes

( ) No

ATTACH DETAILED PLAN OF SUPERVISION, ie., DEPOSIT OF MONIES, REVIEW OF

CONTRACTS, ADVERTISING, SUPERVISION, TRAINING, AND ADHERENCE TO LICENSE

LAW AND REGULATIONS, ETC.

Name, number and location of trust account: ___________________________________________________

_______________________________________________________________________________________

$75 fee

___________________________________

Signature________________________________________

DATE

(RESPONSIBLE BROKER)

Application For Branch Office License Form 2000