MOR Member Office Transfer Form - Outgoing

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

(Limited Function Referral Changes do not need to be made with the Board of Realty Regulation.)

Brokerage Name *

Please Enter Your Brokerage Name

Designated REALTOR Name: *

Email *

(A copy of this completed form will go to this email address)

First Name of Licensee: *

Last Name of Licensee: *

Licensee's NRDS ID *

Licensee's NRDS ID

Effective Date *

Effective Date for Transfer

Comments

Comments (please tell us where this licensee is transferring too if you have this info): 

Designated REALTOR® Acknowledgement *

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

I agree

Date of Acknowledgement *

Date of Acknowledgement