Li 216 Form PDF Details

The Arizona Department of Real Estate (ADRE) provides a comprehensive protocol for brokers and entities engaged in the real estate sector to modify their operational status or organizational details via the LI-216 form. This form encompasses a wide array of changes, including transitions from inactive to active status for brokers, updates to the legal or "doing business as" (DBA) names of entities, and shifts in the designation of brokers or sole proprietors within a firm. It mandates thorough details regarding the licensing individual or entity, including name, license number, and expiration dates, ensuring that all alterations are properly documented and legally valid. The form also makes provisions for out-of-state brokers, highlighting Arizona’s specific requirements for non-resident employing brokers to establish trust accounts and maintain transaction records within the state. With a well-structured section on business type changes, the LI-216 form stands as a critical document for maintaining the accuracy and legality of real estate brokerage operations within Arizona, encapsulating a meticulous process designed to uphold the integrity and regulatory compliance of the state’s real estate industry.

QuestionAnswer
Form NameLi 216 Form
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesdesignated arizona yes, entity arizona yes, change adre address print, db designated arizona

Form Preview Example

ARIZONA DEPARTMENT OF REAL ESTATE (ADRE)

JANICE K. BREWER

 

Licensing Division

GOVERNOR

www.azre.gov

JUDY LOWE

 

2910 N. 44th Street, Phoenix AZ 85018

COMMISSIONER

 

ENTITY/BROKER STATUS CHANGE (LI-216)

SELECT TYPE OF CHANGE(S)

Entity Legal Name/DB Name

DB Change For Existing Entity

Inactive Broker Change to Active DB

Associate Broker Change to DB for Existing Entity

Associate Broker Change to SE

New Broker Licensee to DB

Resident Broker Change to Non-Resident Broker (out-of-state Principal Office Address)

DB Change to SE

Active DB Change to Inactive Change Entity to Inactive SE to Inactive

SELECT BUSINESS TYPE

Corporation (CO)

Limited Liability Company (LC)

Partnership (PA)

Limited Liability Partnership (PA)

Broker

Designated Broker (DB)

SECTION 1:DESIGNATED BROKER (DB)/SOLE PROPRIETOR (SE)/LICENSEE INFORMATION

Sole Proprietor (SE) Salesperson

DB/SE/Licensee Name (First MI Last)

 

DB/SE/Licensee License #

DB/SE/Licensee License Expire Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Email

 

 

Phone:

 

 

Fax:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Questions

 

 

 

 

 

Responses

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.

 

How is the Incoming Licensee currently licensed?

 

 

 

(DB)

(SE) (attach LI-201A)

 

 

Associate Broker

 

Salesperson

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

 

Is the Incoming DB/Sole Proprietor currently employed as “active status”?

Yes

 

 

 

No – go to question 6

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

 

Is the prior current/prior licensed entity closing?

 

 

 

Yes – go to Question 5

 

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.

 

Is the prior licensed entity appointing a new DB (if not closing)?

Yes – go to Question 6

 

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5.

 

Does the prior licensed entity have “active” agents?

 

 

 

Yes – refer to Instructions

 

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6.

 

As the changing Broker, are continuing education (CE) requirements current?

Yes

 

 

 

No – STOP, Reapply when current

 

 

ARS §32-2130

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7.

 

As the changing Broker, has a 9-hour Broker Management Clinic been

Yes – Date ________________

 

No – STOP, Reapply when current

 

 

completed within 23 months prior to this application? ARS §32-2136 (C)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8.

 

Is there a joint PC or PLLC with ADRE for the incoming DB’s name?

Yes - STOP, Amend to single PC or

 

No

 

 

 

 

ARS §32-2125 (B)

 

 

 

PLLC with the ACC and reapply

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9.

 

Does this DB have a PC or PLLC in good standing with the Arizona Corporation

Yes

 

 

 

No - STOP,

 

 

Not

 

 

Commission?

 

 

 

 

 

 

 

Reapply

 

Applicable

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10.

 

Will this DB reside outside of the State of Arizona

 

 

 

Yes – complete Non-Resident

 

No

 

 

 

 

 

 

 

 

Broker section below

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION 2: ENTITY/EMPLOYING BROKER INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Legal Name (as approved by ADRE)

 

 

 

 

 

 

 

EIN (Employer Identification

 

 

 

 

 

 

 

 

 

 

Number) or Tax ID # (Required)

 

 

 

 

 

 

 

 

 

 

 

 

 

Doing Business as (DBA) – if any (as approved by ADRE)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Physical Address of Entity

 

 

 

Suite

City

 

 

 

State

 

Zip

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address of Entity: Same as Physical Address

 

 

 

Suite

City

 

 

 

State

 

Zip

 

 

 

 

 

 

 

 

 

 

 

 

 

Email

 

 

Phone:

 

 

Fax:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Entity License Number:

Entity Expiration Date (Aligned)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ENTITY/EMPLOYING BROKER/BROKER STATUS CHANGE (LI-216)

Rev. 04/2014

 

 

 

 

 

 

 

 

 

SECTION 3: SELECT BUSINESS TYPE OF CHANGE(S) BEING MADE

ENTITY

LEGAL/DBA

 

NAME

If CO or LLC amended articles stamped “FILED” by the Arizona Corporation Commission (ACC). Do not submit until

CHANGE

 

 

 

 

 

a stamped “FILED” copy is received.

 

 

 

 

 

 

 

If Partnership, copy of addendum/amendment to Partnership Agreement showing change.

 

 

 

 

 

 

ADRE Entity/Employing Broker Name Reservation Notice (ADRE Approval Notice)

 

 

 

 

 

 

DESIGNATED

 

BROKER

(DB)

A copy of the resolution signed by all officers and directors electing/appointing a DB as a corporate officer, naming

CHANGE FOR EXISTING ENTITY

the office held and stating that the individual was appointed to act as the DB for the corporation.

 

 

 

 

 

 

Amended Articles stamped “Filed” by the AZ Corporation Commission (ACC). If an LLC entity, the amendment

 

 

 

 

 

 

must name the DB as a member/manager of the LLC. Do not submit until a stamped “Filed” copy is received.

 

 

 

 

 

 

Letter of resignation of outgoing DB (attached).

 

 

 

 

 

 

 

Incoming DB severed on-line, if not a Branch Manager at prior company.

 

 

 

 

 

 

Copy of Salesperson/Associate Broker Change Form LI-202 signed by prior DB, if incoming DB was a Branch

 

 

 

 

 

 

Manager at prior company. (Attached)

 

 

 

 

 

 

 

Copy of Certificate of Broker Management Clinic taken within prior 23 months.

 

 

 

 

 

 

 

DESIGNATED

 

BROKER

(DB)

Letter of resignation as outgoing DB (attached).

 

CHANGE TO SOLE PROPRIETOR

Copy of Certificate of Broker Management Clinic taken within prior 23 months.

(SE)

 

 

 

 

 

When current Entity closing, follow closing procedure with Auditing.

 

 

 

 

 

 

 

 

 

 

 

 

ADRE Approved Entity/Employing Broker Name Reservation Notice.

 

 

 

 

 

 

Sever licensees online, only when instructed by ADRE to do so.

 

 

 

INACTIVE BROKER CHANGE TO

When becoming Designated Broker (DB) for an existing Entity, complete “Designated Broker (DB) Change For

ACTIVE

DESIGNATED

BROKER

Existing Entity” on Form LI-216.

 

(DB)

 

 

 

 

 

Unlawful License Activity Statement Form LI-555.

 

 

 

 

 

 

 

ASSOCIATE

BROKER

CHANGE

Sever from current Broker.

 

TO DESIGNATED BROKER (DB)

When becoming Designated Broker for existing entity, complete the “Designated Broker Change For Existing

FOR EXISTING ENTITY

 

 

Entity” on Form LI-216.

 

 

 

 

 

 

 

ACTIVE

DESIGNATED

BROKER

Letter of resignation from current Entity.

 

(DB) CHANGE TO INACTIVE

Sever all licensees by using the Online Licensing System after notifying them of change. All Licensees may then

 

 

 

 

 

 

rehire Online from their personal page.

 

 

 

 

 

 

 

ASSOCIATE

BROKER

CHANGE

Sever online from prior entity.

 

TO SOLE PROPRIETORSHIP (SE)

When Branch Manager – “Salesperson/Associate Broker Change Form LI-202” signed by prior DB.

 

 

 

 

 

 

Copy of Certificate of Broker Management Clinic taken within prior 23 months.

 

 

 

 

 

 

When Inactive to Active – confirm continuing education (CE) is up-to-date.

 

 

 

 

 

 

NEW

BROKER

LICENSEE

All documents for Original Broker Application.

 

CHANGE

TO

DESIGNATED

When becoming Designated Broker for existing entity, complete the “Designated Broker Change for Existing

BROKER

(DB)

FOR

EXISTING

Entity” on this Form LI-216.

 

ENTITY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CHANGE

ENTITY TO

INACTIVE

Letter of Resignation of DB.

 

STATUS

 

 

 

 

 

Procedure for closing office with Auditing completed.

 

 

 

 

 

 

 

Complete Form LI-216

 

 

 

 

RESIDENT BROKER CHANGE TO A NON-RESIDENT BROKER (Out-of-State Principal Office Address)

TRUST ACCOUNT INFORMATION –established with a Financial Institution located in Arizona

AAC R4-28-302(A)

Check if using Arizona Based Title Company only

 

 

 

 

 

 

 

Trust Account Name

 

 

 

 

Trust Account Number

 

 

 

 

 

 

 

 

 

Financial Institution Name

Phone:

Fax:

Branch Address:

Street #

Street Name

Suite

City

State

Zip

Additional account information attached.

ENTITY/EMPLOYING BROKER/BROKER STATUS CHANGE (LI-216) Rev. 04/2014

ARS §§32-2151.01(A); 32-2163 and R4-28-302(L)

NON-RESIDENT EMPLOYING BROKER INFORMATION –

A non-resident broker who maintains a principal office outside of Arizona shall:

Establish a trust account in Arizona

Maintain all records of transaction in Arizona –

Appoint a Custodian of Records

Custodian Name:

Address:

Email

Phone:

Fax:

A non-resident Employing Broker who employs any licensee(s) in the State of Arizona shall complete below:

Establish a branch office and appoint an Arizona licensed Branch Manager other than self.

Branch Office Information (of non-resident Employing Broker)

Legal Name

 

 

 

 

Phone:

 

 

 

 

 

 

 

 

 

Doing Business As (DBA) – if any

 

 

 

Fax:

 

 

 

 

 

 

 

 

 

 

Business Address:

 

 

Suite

City

 

 

State

Zip

 

 

 

 

 

 

 

 

 

Mailing Address:

Same as above

 

Suite

City

 

 

State

Zip

 

 

 

 

 

 

 

 

Branch Manager (of non-resident Employing Broker)

 

 

 

 

 

 

 

 

 

 

 

 

Name (First MI Last):

License #:

 

 

License Expiration Date:

 

 

 

 

 

 

 

Email:

 

Phone:

 

 

Fax:

 

 

 

 

 

 

 

 

 

 

Describe the authority vested in the branch manager – ARS §32-2127 and AAC R4-28-304

Describe how the licensed employee(s) will be supervised – R4-28-302(L) & AAC R4-28-1103

I, __________________________________________________________________ acknowledge that I have read and understand the responsibilities set forth above.

Branch Manager Name

Branch Manager Signature _____________________________________________________________ Date _____________________________________________

Print Designated Broker/ Broker/ SE Licensee Name_______________________________________________________________________________

Designated Broker/ Broker/ SE/ Licensee Signature_________________________________________ Date___________________________________

FOR ADRE USE ONLY

Effective Date

 

 

 

Date Stamp

Receipt

 

 

 

 

 

 

Input Date

 

 

 

 

 

 

 

 

 

 

 

Time Frames

TF 1

TF 2

 

 

 

 

 

 

 

 

 

Processed By

 

 

 

 

 

 

 

 

 

 

 

ENTITY/EMPLOYING BROKER/BROKER STATUS CHANGE (LI-216)

Rev. 04/2014

 

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This PDF form requires particular information to be typed in, therefore you should definitely take your time to type in precisely what is requested:

1. Complete the change adre address form with a selection of major blanks. Get all the important information and make certain absolutely nothing is missed!

The best ways to fill out change adre address portion 1

2. After performing the previous part, head on to the subsequent step and fill out the essential particulars in these fields - Is the prior currentprior licensed, Yes go to Question, Is the prior licensed entity, Yes go to Question, Does the prior licensed entity, Yes refer to Instructions, As the changing Broker are, Yes, No STOP Reapply when current, ARS, As the changing Broker has a hour, Yes Date, No STOP Reapply when current, Is there a joint PC or PLLC with, and Yes STOP Amend to single PC or.

A way to fill in change adre address step 2

3. This third segment is generally pretty simple, Mailing Address of Entity Same as, Suite, City, State, Zip, Email, Phone, Fax, Entity License Number, Entity Expiration Date Aligned, and ENTITYEMPLOYING BROKERBROKER - every one of these form fields will have to be filled out here.

A way to fill in change adre address part 3

4. This specific subsection comes with these blanks to fill out: Complete Form LI, RESIDENT BROKER CHANGE TO A, TRUST ACCOUNT INFORMATION, AAC RA, Check if using Arizona Based Title, Trust Account Name, Trust Account Number, Financial Institution Name, Phone, Fax, Branch Address, Street, Street Name, Suite, and City.

Trust Account Name, Street, and Check if using Arizona Based Title in change adre address

Always be very mindful when filling in Trust Account Name and Street, because this is where most users make mistakes.

5. The form must be wrapped up by dealing with this segment. Below you'll see an extensive set of form fields that need to be filled in with accurate information in order for your form submission to be complete: Establish a trust account in, Custodian Name, Address, Email, Phone, Fax, A nonresident Employing Broker who, Establish a branch office and, Branch Office Information of, Legal Name, Doing Business As DBA if any, Business Address, Mailing Address, Same as above, and Phone.

Stage no. 5 in completing change adre address

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