Employing Broker Notification Form PDF Details

In order to comply with SEC Rule 15c2-26, which requires security firms that are registered with the SEC to notify their customers of their role in the distribution of securities, firms must use a Form ADV Broker Notification (Form BD) to notify their customers. The notification must include certain information, including the customer's account number and whether or not the customer has been notified about placing an order for a particular security. This form is also used to inform customers of any disciplinary events that have occurred involving the broker or firm. The notification must be sent out within 10 days of any event that triggers the requirement. Firms can use either paper or electronic forms to send out notifications. If you opted for electronic delivery, you would need to include an email address or website URL where recipients could go to access the form. You would also need to provide instructions on how recipients can print out copies of the form if they choose not

QuestionAnswer
Form NameEmploying Broker Notification Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesbroker notification form michigan, state of michigan real estate employing broker notification form, michigan employing broker, michigan application of employing broker form

Form Preview Example

BCS/LRE-052 (10/11)

Michigan Department of Licensing and Regulatory Affairs Bureau of Commercial Services

Licensing Division

REAL ESTATE

P.O. Box 30243, Lansing, MI 48909

517-373-7353 Fax: 517-373-1044 www.michigan.gov/realestate

DEPARTMENT USE ONLY

ID # 65-01

Date Approved

Approved By

EMPLOYING BROKER NOTIFICATION

AUTHORITY:

P.A. 299 of 1980, as amended

COMPLETION:

Mandatory

PENALTY:

Failure to complete may result in denial of your application

 

 

 

INSTRUCTIONS AND INFORMATION

 

 

1.This form may only be used by NEW salesperson applicants who have applied for licensure at the www.michigan.gov/icola website and did not list a broker when applying, or have changed brokers after applying on iCOLA prior to license exam. This form is required

to affiliate with the proper broker. If you do not submit this form your license will remain pending in the database or may be issued to the incorrect broker.

2.Salesperson license applications filed on iCOLA are valid one year from the date of first applying. If application is over one year old; you must re-apply on iCOLA at www.michigan.gov/iCOLA.

3.TYPE OR PRINT CLEARLY IN BLACK INK.

4.Fill out this form, sign it and have your employing broker also sign. Mail the form to the address listed above, or fax to: 517-373-1044. If you are faxing this form, please do not mail the original.

APPLICANT INFORMATION

Applicant's Legal Name (First, Middle, Last)

Home Address (Number and Street)

City

State

ZIP

E-mail Address

Daytime Phone Number

Social Security Number

Date of Birth

Date Passed Exam

EMPLOYING BROKER INFORMATION

Broker Name - as shown on Broker's license. DO NOT USE DBA, Associate Broker or Branch Office.

Broker's License I.D. Number

65-

AFFILIATION REQUEST (both the applicant and broker must sign)

We request that the Department issue applicant a real estate saleperson's license. If the license is issued, the broker agrees to exercise careful supervision over the salesperson's real estate activities.

Signature of Salesperson Applicant

 

Date

 

 

 

Signature of Employing Broker/Associate Broker

 

Date

 

 

 

Licensed Name of Employing Broker (Please print or type)

 

 

LARA is an equal opportunity employer/program. Auxiliary aids, services and other reasonable accommodations are available upon request to individuals with disabilities.

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Writing section 1 in lara notification to emplying broker

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lara notification to emplying broker conclusion process detailed (portion 2)

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