LCCI-0 (06/20/2016)

TEXAS REAL ESTATE COMMISSION P.O. Box 12188

Austin, Texas 78711-2188 www.trec.texas.gov (512) 936-3000

LICENSE HOLDER CHANGE OF CONTACT INFORMATION

DO NOT WRITE ABOVE THIS LINE

FEE RECEIPT NUMBER AMOUNT

Processing Fee $20.00

THE INFORMATION MUST BE TYPED OR PRINTED IN INK.

This change of information is for a

This document is available on the TREC website at www.trec.texas.gov

The required fee to change contact information is $20.00. The fee MUST be a SINGLE REMITTANCE. TREC will NOT issue a license from this form without payment of the required fee.

Please note that a license holder may change contact information online at www.trec.texas.gov at no cost.

NEW MAILING ADDRESS

License # Entity #

File#App#

Sales Agent

Telephone Number

$ TYPE

Broker

Corporate or LLC Broker

Email address

License No:

Apprentice Inspector

Real Estate Inspector

Professional Inspector

Inspector Corporation or LLC

Easement or Right-of-way Registration for an Individual

Easement or Right-of-way Registration for an BusinessRegistration No:

This change of information is for a(n):

License No:

License No:

License No:

License No:

License No:

License No:

Registration No:

Expiration Date:

Expiration Date:

Expiration Date:

Expiration Date:

Expiration Date:

Expiration Date:

Expiration Date:

Expiration Date:

Expiration Date:

Please make the following changes to my contact information on file with the Texas Real Estate Commission. This does not change the business address shown on a license.

NEW MAILING ADDRESS (May be a P.O. Box)

Web site address

To change a business address or reprint a license, a broker or professional inspector must use the Change of Main Office Address by Broker, Professional Inspector, Easement or Right-of-Way Registrant and or Reprint of License or Registration form found at the TREC website www.trec.texas.gov.

*If Business entity: printed name and signature of Designated Broker is required.

DateSignature*Printed Name*