Firm Address Change Request

An image of the North Carolin Real Estate Seal.

This form may be used to change ONE address that is used by one or more Firms/Sole Proprietorships.
To change multiple addresses, please complete a separate form for each address.
Commission Rule 58A.0502(c)(4) requires the Qualifying Broker to notify the Commission of any change of business address of the firm; Rule 58A .0110(g)(2) requires the Broker-in-Charge to notify the Commission of any change of business address of his/her office location.

Contact Details

Your License Number*

Your First Name*

Middle Name

Last Name*

Your Public Phone

Your Private Phone*

Your Public Email

Your Private Email*

Firm Address Information

Current Address on Record with the Commission

Physical Address*

Physical City*

Physical State*

9-Digit Zipcode Lookup*

Mailing Address

Mailing City

Mailing State

9-Digit Zipcode Lookup

New Address

New Physical Address*

New Physical City*

New Physical State*

9-Digit Zipcode Lookup*

New Mailing Address (if different)

New Mailing City

New Mailing State

9-Digit Zipcode Lookup

How many Firms/Sole Proprietorships have been using this address?*

Only ONE Firm or Sole Proprietorship has been using this address

Multiple Firms/Sole Proprietorships have been using this address

NOTES:

A broker may serve as Broker-in-Charge (BIC) at only one address. If one BIC has been designated for all firms/sole proprietorships at this address, but the address is not changing for all firms/sole proprietorships, one or more locations will no longer have a BIC and all brokerage activities must cease. If you are unsure whether this applies, please contact the Commission’s Education and Licensing Division at 919.875.3700 before completing this form.
If firms are moving to separate addresses, complete a separate form for each unique address.

Enter the names and firm license numbers for all Firms/Sole Proprietorships that will use the new address. You may enter up to five locations on this form. If you need to add more locations please contact the Commission’s Education and Licensing Division.

How many Firms/Sole Proprietorships will be using the new address?*

Location #1