Request FIRM Name Change and/or Request to Replace
FIRM License Certificate or Pocket Card

An image of the North Carolin Real Estate Seal.

The Real Estate Commission can reissue a real estate license certificate and/or pocket card only if the firm name has been legally changed or if the original license certificate or pocket card has been lost or damaged or was never received.
This form should only be used to request a FIRM name change. To request a broker name change, please use the Request to Reissue BROKER Real Estate License Certificate and/or Pocket Card.
Payment may be made with a Visa, MasterCard, American Express, Discover, or valid PayPal account.
All fees are non-refundable.

Request Details

Your License Number*

Your First Name*

Your Middle Name

Your Last Name*

Your Email Address

Current name of Firm or Sole Proprietorship*

Is this a Firm or Sole Proprietorship*

Firm License Number*

Are you changing the name of the Firm OR Adding/Dropping an Assumed Name?*

I hereby certify to the North Carolina Real Estate Commission that:*
*Please note that a Qualifying Broker may view/download/print the firm’s digital pocket card for no charge by logging into his/her license record.

My firm real estate license certificate has been lost or damaged, and I request a replacement ($5 fee required).

My firm real estate license pocket card has been lost or damaged, and I request a paper replacement. ($5 fee required).*

My firm real estate license certificate was never received, and I request a replacement (Only select this option if your request is within 45 days of license issuance).

My firm real estate license pocket card was never received, and I request a paper replacement. (Only select this option if your request is within 45 days of license issuance or renewal/reinstatement).*

The legal name of the firm has changed OR an assumed name has been added or removed. Please mail an updated license certificate ($5 fee required). I will download an updated digital pocket card (at no charge) once my firm name change has been processed.

The legal name of the firm has changed OR an assumed name has been added or removed. Please mail an updated license certificate ($5 fee required) and an updated paper pocket card ($5 fee required).*

Are you changing the name for all locations of this Firm/Sole Proprietorship or only select locations?*

How many locations will be using the new name? *
You can enter up to five locations. If you need more than five locations please attach a list in the additional documents section at the end of this form.

Location #1