Notification Of Change Of Address/firm Name Form

Notification Of Change Of Address/firm Name Form - 2000

03/00

WYOMING REAL ESTATE COMMISSION

2020 CAREY AVENUE, SUITE 100

CHEYENNE, WYOMING 82002-0180

(307) 777-7141

NOTIFICATION OF CHANGE OF ADDRESS/FIRM NAME

RESPONSIBLE BROKER _______________________________________________________

FIRM NAME __________________________________________________________________

______________________________________________________________________________

BUSINESS PHONE NUMBER

FAX

E-MAIL

__________________________

EFFECTIVE DATE OF ADDRESS CHANGE OR FIRM NAME CHANGE

* Change of address: ($10 fee per license)

OLD: ________________________________________________________________________

ADDRESS

CITY

STATE

ZIP

NEW: ________________________________________________________________________

ADDRESS

CITY

STATE

ZIP

Box No., if any _________________

** Change of firm name:

($20 fee per license)

FROM: _______________________________

TO: ________________________________

OFFICE COMPLIES WITH LOCAL ZONING REGULATIONS

( ) YES

( ) NO

A SIGN IS CONSPICUOUSLY DISPLAYED ON PREMISES

( ) YES

( ) NO

Date: __________________________

(Signed) __________________________________

(Responsible Broker)

NOTE: The change of firm name fee is $20 per license.

The change of address fee is $10 per license.

For example, if there is 1 broker, 2 associate brokers and 3 salespeople licensed in an office, the fee

for the Change of Address would be $60.

If you are establishing an office in your home, a letter from your local zoning office is required

showing approval.

*Licenses and pocket cards bearing old address must be returned to the Commission office

immediately after receiving new licenses.

**Licenses and pocket cards bearing old firm name must be returned to the Commission office with

the fee at the time of application for the name change.

Notification Of Change Of Address/firm Name Form - 2000

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