Free 49384.PDF - Indiana

INDIANA REAL ESTATE COMMISSION BRANCH OFFICE REGISTRATION
State Form 49384 (4-99)

NO FEE

INDIANA PROFESSIONAL LICENSING AGENCY INDIANA REAL ESTATE COMMISSION 302 W. WASHINGTON STREET, ROOM E034 INDIANAPOLIS, IN 46204 TELEPHONE (317) 232-2980 FAX (317) 232-2312

* A BROKER MAY NOT MANAGE MORE THAN ONE OFFICE. * A PRINCIPAL BROKER MAY NOT MANAGE A BRANCH OFFICE. * BRANCH MANAGER MUST BE A BROKER-SALESPERSON ASSOCIATED WITH THE PRINCIPAL BROKER.

Name of company

Company license number

Company address (number and street, city, state, ZIP code)

Telephone number

Principal broker

Signature

License number

Branch office location (number and street, city, state, ZIP code)

Telephone number

Branch office managing broker

Signature

License number

INDIANA REAL ESTATE COMMISSION BRANCH OFFICE REGISTRATION
State Form 49384 (4-99)

NO FEE

INDIANA PROFESSIONAL LICENSING AGENCY INDIANA REAL ESTATE COMMISSION 302 W. WASHINGTON STREET, ROOM E034 INDIANAPOLIS, IN 46204 TELEPHONE (317) 232-2980 FAX (317) 232-2312

* A BROKER MAY NOT MANAGE MORE THAN ONE OFFICE. * A PRINCIPAL BROKER MAY NOT MANAGE A BRANCH OFFICE. * BRANCH MANAGER MUST BE A BROKER-SALESPERSON ASSOCIATED WITH THE PRINCIPAL BROKER.

Name of company

Company license number

Company address (number and street, city, state, ZIP code)

Telephone number

Principal broker

Signature

License number

Branch office location (number and street, city, state, ZIP code)

Telephone number

Branch office managing broker

Signature

License number