Form Rec 1.79 - Declaration Of Affiliation Of Limited Commercial License - North Carolina Real Estate Commission Page 2
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2DECLARATION OF NORTH CAROLINA RESIDENT BROKER
By signing below, the North Carolina resident broker acknowledges that he or she:
•
Is a resident, individual North Carolina broker (not a firm) on “active status” with the North Carolina Real Estate
Commission;
•
Is affiliated with the limited nonresident commercial licensee named in this Declaration;
•
Shall actively and personally supervise the limited nonresident commercial licensee in a manner which
reasonably assures that he or she performs all acts for which a limited nonresident commercial license is
required in accordance with the North Carolina Real Estate License Law and Commission Rules;
•
Has verified that the limited nonresident commercial licensee has a current North Carolina Limited Nonresident
Commercial Real Estate Broker or Salesperson License;
•
Shall promptly notify the Commission if the limited nonresident commercial licensee violates the North Carolina
Real Estate License Law or Commission Rules;
•
Shall maintain and retain all documents and records relating to transactions conducted under this Declaration
of Affiliation;
•
Shall assure that all advertising in connection with transactions conducted under this Declaration of Affiliation
includes the name of the North Carolina broker and identifies the limited nonresident commercial licensee as
a Limited Nonresident Commercial Real Estate Broker if the advertising also contains the name of the limited
nonresident commercial licensee;
•
Shall remit to the real estate firm with which the limited nonresident commercial licensee is associated during
the term of this Declaration of Affiliation any brokerage fee or other compensation earned by the limited
nonresident commercial licensee which is received by the North Carolina broker;
•
Shall assure that all offers and sales contracts for property subject to this Declaration of Affiliation identify each
real estate agent and firm and nonresident commercial licensee involved in the transaction and who they
represent; and
•
Shall enter into a brokerage cooperation agreement as required by and in accordance with 21 NCAC 58A.
1807(b) in connection with any transaction(s) undertaken pursuant to this Declaration of Affiliation.
FULL NAME:______________________________________________ LIC. # ___________________________
RESIDENCE ADDRESS: ______________________________________________________________________
FIRM NAME & ADDRESS: ____________________________________________________________________
(Primary Place of Business in Qualifying State)
PHONE: ______________________ FAX: ______________________ EMAIL: ___________________________
RESIDENT BROKER SIGNATURE: ________________________________________DATE: ______________
REC 1.79F
Page 2 of 2
8/06
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