MOR Member Change Form

I acknowledge that this change has been completed with the Board of Realty Regulation *

Yes

No

N/A

Designated REALTOR® (DR) Name: *

Status Change *

Please choose one option below:

License moved to Inactive with BRR

No longer Associated with my Brokerage

License moved to Active with BRR

Moved out of LFRO, active with my Brokerage

Brokerage's membership is being terminated

Change of Primary Association

First Name of Licensee: *

Last Name of Licensee: *

Licensee's Email Address: *

If the licensee has an alternative email address from their brokerage provided email (if applicable), please provide that. MOR may need this to contact the licensee. 

Member's NRDS ID

Member's 9-digit NRDS ID or also called their Member ID. If you are unsure, you may leave this blank. 

Effective Date of Change *

Effective Date of Member Status Change:

Comments

Comments:

Designated REALTOR® Acknowledgement (Responsbility): *

By agreeing, I acknowledge that as the Designated REALTOR® of the office, that I am taking responsibility or releasing responsibility for the above-named licensee.

I agree

Designated REALTOR® Acknowledgement (SentriLock): *

By agreeing, I acknowledge that if this licensee is no longer associated with my brokerage and/or has moved their license to inactive status, that any SentriLock lockboxes currently assigned to the licensee must be returned to the MOR office (724 Burlington Ave, Missoula) within the next five (5) business days. If not, I, the Designated REALTOR®, will be notified and billed for each outstanding Lockbox. 

I agree

Date of Acknowledgement *

Date of Acknowledgement