Maryland Department of Labor



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DO NOT WRITE IN THIS SPACE

RECEIVED

FEE $

CK ( ) MO ( )

Branch Office Lic Reg. Cert No_________

Date Issued: ________________

STATE OF MARYLAND

DEPARTMENT OF LABOR

DIVISION OF OCCUPATIONAL AND PROFESSIONAL

LICENSING

REAL ESTATE COMMISSION OF MARYLAND

500 NORTH CALVERT ST, 3RD FLOOR BALTIMORE, MD 21202

MREC e-mail dlmrec-dllr@



DO NOT SEND CASH

ALL FEES MUST BE PAID BY CHECKOR MONEY ORDER,

PAYABLE TO THE MARYLAND REAL ESTATE COMMISSION (MREC)

This application to be used only by a licensed Real Estate Broker who desires to maintain a Branch Office or offices in addition to

his/her principal place of business. A separate application must be submitted for each branch office request.

1. Name of Broker

First Middle Last

2. Trade Name

Type or Print

3. Main Office Address

Street and Number Telephone Number

4. State here the location of the offices for which Branch Office is requested:

Street and Number

City County Zip Code Telephone Number Fax Number

The Manager of the Branch Office must have at least three (3) years’ experience.

INDICATE WHO WILL MANAGE THIS OFFICE

First Middle Last License Type

License Registration Certificate No. Private Email Address

Public Email Address [pic]

Signature of Broker only[pic]

Date of Application Broker License Registration No.

DLLR/MREC/ 8/19/19

APPLICATION FOR BRANCH OFFICE LICENSE

LICENSE FEE $ 5.00

ALL ITEMS MUST BE COMPLETED IN ORDER TO PROCESS APPLICATION

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