Continued on reverse side STATE OF CALIFORNIADEPARTMENT OF þRREAL þEEþsSTATECORPORATION CHANGE þAAPPLIþcCATION RE 204A (Rev. 7/18) CORPORATION INFORMATION1. DRE CO þrR PO þrR ATION LIC þeE NS þeE NUMB þerER 2. F þederEDER AL TAXPAY þerER I þdD NUMB þerER (REQUI þrR ED-SEE P þrR IVACY NOTICE)D þRR E USE þONON LY - þEE FF. þDD ATE OF þCC HANGE3. þCC O þrR PO þrR ATION þNN AM þeE 227 þPrPR INT þeE XACTLY AS SHOWN ON LIC þeE NS þeE C þerER TIFICAT þeE .CORPORATION CHANG þesES 4. NEW þCC O þrR PO þrR ATION þNN AM þeE , IF CHANGING 227 þPrPR INT AS SHOWN ON AM þeE N þdedDED þArAR TICL þeE S OF þII NCO þrR PO þrR ATION5. þCC O þrR PO þrR ATION þMM AILING þAddreADDRE SS 227 þSS T þreeREE T þAddreADDRE SS O þrR þPP OST þOO FFIC þeE þBB OX þCC ITY þSS TAT þeE ZIP þCC O þdeDE 6. þCCOþrRPOþrRATION þMMAIN þOOFFICþeE þAddreADDRESS 227 þSSTþreeREET þAddreADDRESS þCCITY þSSTATþeE ZIP þCCOþdeDE þCACA 7. þFF ICTITIOUS þBB USIN þeE SS þNN AM þeE , IF A þddDD ING O þrR CANC þeE LING 227 þPrPR INT AS IT APP þeE A þrR S ON COUNTY CL þerER K222S FILING. þAA DD þCC ANCEL þAA DD þCC ANCELTRAN þsS F þeE R " þdesDES IGNAT þedED OFFIC þeE R" TIT þleLE TO ANOTH þeE R " þlL IC þeE N þsedSED OFFIC þeE R"8A. þNN AM þeE OF CU þrreRRE NT þdeDE SIGNAT þedED OFFIC þerERþCC O þrR PO þrR AT þeE þOO FFIC þerER þTT ITL þeE , IF þreRE MAINING WITH CO þrR P. 8B. þCC U þrreRRE NT D þeE SIGNAT þedED þOO FFIC þerER 227 þCC H þeE CK þOO N þeE STAT þeE M þeE NT þII AM þrR EMAINING WITH THE FI þrR M A þsS A LICEN þsS ED OFFICE þrR . þII AM NOT þrR EMAINING WITH THE FI þrR M A þsS A LICEN þsS ED OFFICE þrR .8C. þSS IGNATU þreRE OF CU þrreRRE NT þdeDE SIGNAT þedED OFFIC þerER DAT þeE 8 þdD . þNN AM þeE OF þnN EW þdeDE SIGNAT þedED OFFIC þerER 8E. þLL IC þeE NS þeE þIdID þNN UMB þerER 8F. þCC O þrR PO þrR AT þeE þOO FFIC þerER þTT ITL þeE 8G. þSS IGNATU þreRE OF þnN EW þdeDE SIGNAT þedED OFFIC þerER DAT þeEþlL IC þeE N þsedSED BROK þeE R-OFFIC þeE R CHANG þesES 9. þOO FFIC þerER 222S þNN AM þeE 227 þPrPR INT AS SHOWN ON LIC þeE NS þeE C þerER TIFICAT þeE D þRR E USE þONON LY10. þOO FFIC þerER 222S NEW þPerPER SONAL þNN AM þeE , IF CHANGING 227 þLL AST, þFF I þrR ST, þMM I þddDD L þeE 11. DO YOU þreRE SI þdeDE IN þCC ALIFO þrR NIA?.............................................................................................................................................................................. þII F þNONO , AN 223RE 234224 MAY B þeE þreRE QUI þredRED . þSeeSEE PAG þeE 3. þYY E þSS þNONO 12. þBB USIN þeE SS þTeTE L þeE PHON þeE þNN UMB þerER ( )13. ALT þerER NAT þeE þTeTE L þeE PHON þeE þNN UMB þerER ( )14. BUSIN þeE SS þCeCE LL þPP HON þeE NUMB þerER ( )15. BUSIN þeE SS þeE MAIL A þddreDDRE SS þlL IC þeE N þsedSED BROK þeE R-OFFIC þeE R APPROVA þlL 16. þSS IGNATU þreRE OF LIC þeE NS þedED B þrR OK þerER - þOO FFIC þerER DAT þeE D þRR E þuseUSE ON þlyLY EXPI þrR ATION DAT þeEþFF LAG þCC L þeE A þrR ANC þeEþPrPR OC. #DAT þeE þPrPR OC þeE SS þedED DR þEE USE O þnN LY DR þEE USE O þnN LYD þRR E þRR E þCC E þIVIV ED D þATAT E Read instructions on page 3 before completing this application. þ Type or print clearly in black or blue ink. þ Indicate the type of change(s) by marking one or more boxes in the adjacent column.C þorOR P þorOR ATI þonON CHA þnN GES [ þCC heck appropriate box(es)] þMM AILING þAddreADDRE SS T þeE L þeE PHON þeE / þeE MAIL þAddreADDRE SS þMM AIN þOO FFIC þeE þAddreADDRE SS þCC O þrR PO þrR ATION þNN AM þeE þAA CTIVATION D þeE SIGNAT þedED þOO FFIC þerER þAddADD / þCC ANC þeE L þFF ICTITIOUS þBB USIN þeE SS þNN AM þeE BROK þEE R-OFF þII C þEE R C þHAHA N þGESGES þOO FFIC þerER 222S þPerPER SONAL þNN AM þeE þAA CTIVATION OF þOO FFIC þerER American LegalNet, Inc. www.FormsWorkFlow.com RE 204A Page 2 of 3 R þeE G þulUL ATION 2746 þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ (1) þ Received an order or judgment issued by a court or governmental agency during the preceding 10 years temporarily or per-manently restraining or enjoining any business conduct, practice or employment;(2) þ Has had a license to engage in or practice real estate or other regulated profession, occupation or vocation denied, suspended or revoked during the preceding 10 years; þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ or changed person. þ þ þ þ þ þ þ þ þ þ þ þ þ þ C þeE RTIFICATIONI certify that I have read and understand the provisions described above. (check one) þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ than ten percent of the corporation shares including myself. þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ Regulation 2746.17. þCC O þrR PO þrR AT þeE þNN AM þeE 18. þSS IGNATU þreRE OF þOO FFIC þerER þAA PPLICANT (MUST B þeE AN O þrR IGINAL SIGNATU þreRE )DAT þeE American LegalNet, Inc. www.FormsWorkFlow.com RE 204A Page 3 of 3 þGG eneral þII nformation þ þ þ þ þ þ þ þ If the new þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ (RE 201) must be submitted in addition to this form. þ Corporation Background Statement (RE 212) þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ for forming policy of the corporation and all natural persons þ þ þ þ þ þ þ þ þ þ IF such a person has been subject of any of the items enumerated in the þ þ þ þ þ þ þ þ þ þ þ þ þ þ items enumerated in the regulation, then an RE 212 is not needed. þII n all instances þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ Business and mailing addresses are public information and as such þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ mailing address. þ 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. þTT ype of Change þ þ þ þ þ þ þ þ þ þ þ information.Change of Corporation Name þ þ þ þ þ þ þ þ þ appears on the amended Articles of Incorporation. A copy of the amended þ þ þ þ þ þ þ þ þ þ þ þ þ þ Mailing Address þ þ þ þ þ þ þ þ or business address) is used to mail correspondence directly to the corporation.Non-California Residents þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ unavailable, indicate the physical location (i.e., the nearest intersection þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ Fictitious Business Name 227 To add þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ www.dre.ca.gov) to determine if the name is already in use by another broker. þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ To cancel þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ new name. þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ If the new þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ be submitted in addition to this form. þ þ þ þ þ þ þ þ þ þ name change. þ þ þ Mailing þII nformation þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ PR þII VACY þII N þFF ORMAT þII ON: þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ information. þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ shall not be deemed public records and shall not be open to the public for inspection. þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ þ