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ORIGINAL LICENSE FEE

E & O Insurance is required for a

$35.00 for license issued between 10/1/1999 and 9/30/2000

Corporate, Branch or Partnership License

$70.00 for license issued between 10/1/2000 and 9/30/2001

STATE OF ALABAMA REAL ESTATE COMMISSION

1201 CARMICHAEL WAY

MONTGOMERY, ALABAMA

36106

APPLICATION FOR A CORPORATION, BRANCH, OR PARTNERSHIP LICENSE, LLC

1. Name of Corporation, Branch, or Partnership:

____________________________________________________________________________

2. Business Address: ____________________________________________________ ______

(Street and No.)

____________________________________________________________________________

(City)

(State & Zip)

(Office Telephone Number)

3. E-mail address: ____________________________________________________________

4. Name and Home Address of Qualifying Broker: ________________________________

____________________________________________________________________________

5. Date of Formation of Corporation, Branch, or Partnership:___________________

Under Laws of State of _____________________________

6. Has the Corporation or Partnership been licensed in real estate in this or any

other state prior to this application?

If so, give dates and disposition of

same):___________________________________________________________________

7. Has a real estate license issued to the Corporation or Partnership ever been

revoked or suspended in this or any other state? (If so, give details and

dates)______________________________________________________________________

8. a.

If a Corporation, has the Corporation complied with all the laws necessary

for legal incorporation in its home state? ________

the

corporation

registered

business

with

the

office

the

secretary of the state of Alabama? ______

9. a.

If a Branch, you must give the Main Office Address and Telephone Number:

________________________________________________________________________

Will a separate escrow account be maintained for Branch Office? _______ _

your answer is Yes, please furnish the names of person/s responsible for

receipts, deposits, and withdrawals in escrow account:

________________________________________________________________________

Consent is hereby given for ____________________________________________

to be licensed as the qualifying broker for ____________________________

_______________________________________________________ a branch office.

_________________________________________________________

(Signature of Qualifying Broker, Main Office)

10. Give names and addresses of all Officers of the Corporation or Partners of the

Partnership as of date of filing of this application:

NAME OF OFFICER OR PARTNER

TITLE

ADDRESS

____________________________________________________________________________

11. Responsibility is hereby accepted for the actions covered by the Alabama Real

Estate License Law of any and all salespersons licensed under the broker license

issued to the Corporation, Branch, or Partnership Office.

AFFIDAVIT

STATE OF

_______________________________

CITY OF

______________________________ COUNTY OF _____________________________

______________________________________,

for

and

behalf

the

above

named

Corporation, Branch, or Partnership and as the Qualifying Broker, being duly sworn,

deposes and says that he/she has read the herein application and the answers thereon

noted, that such answers are true to his/her knowledge, except as to any matter

therein stated to be alleged upon information and belief, and that as to such matter

he/she believes it to be true and that he/she personally attached his/her signature

to this affidavit.

______________________________________

_______________________________________

(Name of Corp., Branch, or Part.)

(Signature of Qualifying Broker)

The Corporation or Partnership in the proper manner has authorized the filing of

this application for real estate license with the named party as qualifying broker.

_______________________________________________________________________________

(Signature of Corporation Officer or Partner)

(Title)

Sworn to and subscribed before me this _____ day of _____________, 19__

___________________________________________

Notary Public

Application For A Corporation, Branch, Or Partnership License, Llc - Alabama Real Estate Commission

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