Ce Elective Course Sponsor Application (Form Rec 7.06) - North Carolina Real Estate Commission Page 2
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39.
Ownership/Management Information [If the applicant is a business entity, provide the requested information in the appropriate box
below.]
CORPORATION
Corporate Officers. List below the names, corporate titles and percentage of stock ownership of all the major officers (President,
Vice-President(s), Secretary, Treasurer, etc.) of the corporation. [Attach additional sheet(s) if necessary.]
Name __________________________________ Title ____________________________ % of Stock ________
Name __________________________________ Title ____________________________ % of Stock ________
Name __________________________________ Title ____________________________ % of Stock ________
Name __________________________________ Title ____________________________ % of Stock ________
Other Corporate Shareholders. List below any additional persons/entities owning at least 10% of the outstanding shares of
stock of any class and show percentage in parenthesis. [Attach additional sheet(s) if necessary.]
Name_________________________________ (
%) Name ______________________________(
%)
Name _________________________________ (
%) Name ______________________________(
%)
LIMITED LIABILITY COMPANY
Managers and Members. List below the name and mailing address of each manager, as well as the name and address of each
member with an ownership interest of at least 10%. Check “Manager” or “Member” for each person listed and show percentage
of ownership interest in parenthesis. [Attach additional sheet(s) if necessary.]
Name _______________________________________ (
%)
Manager
Member
Address ______________________________________________________________________________________________
Name _______________________________________ (
%)
Manager
Member
Address ______________________________________________________________________________________________
Name ________________________________________(
%)
Manager
Member
Address ______________________________________________________________________________________________
PARTNERSHIP OR OTHER BUSINESS ENTITY
Partners/Principals. List below the name, mailing address and title of any person/entity who serves as a major officer or manager
of the business entity, as well as the name and mailing address of any person who has an ownership interest of at least 10%. For
partners, indicate “General” or “Limited” for each partner listed. Show each listed person’s ownership interest in parenthesis. [At-
tach additional sheet(s) if necessary.]
Name _____________________________________ (
%) Title _____________________________________________
Address ______________________________________________________________________________________________
Name _____________________________________ (
%) Title _____________________________________________
Address ______________________________________________________________________________________________
Name ______________________________________(
%)
General
Limited
Address ______________________________________________________________________________________________
Name ______________________________________ (
%)
General
Limited
Address ______________________________________________________________________________________________
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