WYOMING REAL ESTATE COMMISION 2617 E. LINCOLNWAY, SUITE H CHEYENNE, WYOMING 82002-0180 (307) 777-7141 FAX (307) 777-3796

NOTIFICATION OF CHANGE OF FIRM NAME RESPONSIBLE BROKER: ____________________________________________________ FIRM NAME:

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_______________________________ BUSINESS PHONE NUMBER WEB SITE ADDRESS:

______________________________ FAX

_________________________________ EMAIL **

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EFFECTIVE DATE OF FIRM NAME CHANGE:

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*Change of firm name: $30 fee PER LICENSE to include Corporation, Partnership or Limited Liability Company license. IF YOU DO BUSINESS AS A CORPORATION, LLC, LLP, ETC., YOU WILL ALSO HAVE TO PROVIDE MINUTES indicating the new name. New firm Name: (Printable field is forty (40) letters, including spaces, periods and commas): ___________________________________________________________________________________________

Date: ___________________________ (Signed): ____________________________________________________ (Responsible Broker) * Licenses bearing old firm name must be returned to the Commission office with the fee at the time of application for the name change. ** The WREC primarily communicates through email. Be sure you check your email often and notify the Commission of any changes.