
RE 204 Page 2 of 2
Instructions
Check the appropriate “change” box(es) on page 1 and complete all
information requested on the application.
Change of Personal Name — Enter full new name (do not refer to any
Sign line #12 with your new name. If you have a DBA on record, a Fictitious
Mailing Address
business address) is used to mail correspondence to you.
Non-California Residents — If residing outside the State of California, a
notarized Consent To Service Of Process (RE 234) is also required, if not
of-State Broker Acknowledgment (RE 235).
— Enter the new primary business location. The main
must be a California address. If a street address is unavailable,
indicate the physical location (i.e., the nearest intersection and the distance
to it). If you are no longer working in real estate for which a California
license is required, enter “no business address” on line #6. No license will
be issued unless requested.
Fictitious Business Name — Do not list your broker’s DBA, if you are
working as a broker-salesperson.
To add a DBA to your broker license, enter the name exactly as it appears
site (www.bre.ca.gov) to determine if the name is already in use by
another broker.
FBNS. Refer to Section 2731 of the Commissioner’s Regulations for
restrictions.
To cancel a DBA, complete the entire application. Check the cancel box
on line #11A and list the DBA you wish to cancel.
Mailing Information
Mail To: Bureau of Real Estate
P.O. Box 137004
Sacramento, CA 95813-7004
Try eLicensing
Use eLicensing for expedited processing of your change.
Licensees can perform the following transactions using the eLicensing
system at www.bre.ca.gov:
branch)
General Information
Type or print clearly in ink (black or blue; do not use red).
Business and license mailing addresses are public information and as
such are posted on the Internet and available from BRE via telephone
and written requests. Please consider this when identifying a license
mailing address.
If you electronically re-create this form to facilitate completion on
a computer, the form should not be altered in any manner. To do so,
could result in disciplinary action. Also, please make certain you do
not delete any preprinted information and are using the latest version
of the form.
Broker-Salesperson
to the relationship existing between a licensed real estate salesperson and
an employing broker.
However, such broker-salespersons are still licensed by the Bureau of
Real Estate (BRE) as real estate brokers. Only by written agreement with
another broker are they acting as broker-salespersons. Section 2726 of the
Commissioner’s Regulations requires that “… every real estate broker shall
have a written agreement with each of his salesmen, whether licensed as a
salesman or as a broker under a broker-salesman arrangement.”
Even though a broker may act as a broker-salesperson in a relationship
with another broker, for Bureau of Real Estate licensing and record-keeping
purposes the licensee is still a broker. This means that a broker-salesperson
should still communicate with BRE using only appropriate broker forms
and applications.
name of the broker for whom the broker-salesperson
works. That type of information is irrelevant as there is no reference in the
BRE records that such a working relationship exists. It is also imperative
that a broker-salesperson speak for himself or herself, meaning that any
requests for record changes be made by the broker-salesperson and not by
anyone else on his or her behalf.
A broker-salesperson should never use salesperson forms or applications
when renewing or making changes to a broker record. Doing so will cause
delays in processing whatever is requested. Remember — a broker is
always a broker regardless of any working relationship that may exist
with another broker.
instruCtions
PRIVACY INFORMATION:
Section 1798.17 of the Civil Code requires this notice be provided when
individual has the right to review personal information maintained by
this Agency, unless access is exempted by law.
1651 Exposition Blvd. Licensing, Examinations, & Education
Sacramento, CA 95815 Telephone: 877-373-4542
General powers of the Commissioner, Sections 10050, 10071, and
10075 of the Business and Professions Code authorizes the maintenance
of this information.
Business and Professions Code Sections 30, 31(e) and 494.5(d) require
each real estate licensee to initially provide to the Bureau of Real
Estate his or her social security number which will be furnished to the
Franchise Tax Board. The Franchise Tax Board will use your number
sections also require that each application for a new license or renewal
-
tion and the Franchise Tax Board will share taxpayer information with
the Bureau of Real Estate, and that failure to pay tax obligations may
result in a suspension or denial of a license. The Board of Equalization
and Franchise Tax Board require the Bureau to collect social security
of matching the names of the 500 largest tax delinquencies pursuant to
Section 7063 or 19195 of the Revenue and Taxation Code. Your social
deemed public records and shall not be open to the public for inspection.
The Real Estate Law and the Regulations of the Commissioner require
any part of the required information is not provided, processing may
be delayed. In addition, the Commissioner may suspend or revoke a
license, or in the case of a license applicant, may deny the issuance for
misstatements of facts (including a failure to disclose a material fact) in
an application for a license.
The information requested in this form is primarily used to furnish
license status information to the Bureau’s Enforcement Section, and to
answer inquiries and give information to the public on license status,
mailing and business addresses and actions taken to deny, revoke,
restrict or suspend licenses for cause.
This information may be transferred to real estate licensing agencies in
other states, law enforcement agencies (City Police, Sheriff’s Depart-
ments, District Attorneys, Attorney General, F.B.I.), and any other
regulatory agencies (i.e., Department of Corporations, Department of In-
surance, Department of Consumer Affairs, California Bar Association).