Anne M. Woody Executive Director
Shepherd Mall 2401 NW 23rd Street, Suite 18 Oklahoma City, OK 73107-2431 Telephone (405) 521-3387 Website: www.orec.state.ok.us
“Dedicated To Providing Quality Customer Service”
OKLAHOMA REAL ESTATE COMMISSION
CHANGE OF HOME ADDRESS
Type or print clearly. Please use blue or black ink only. Name _________________________________________________________________________
(Last) (First) (Middle)
Fee: None ____________________
License Number
Please change my home address TO:
Home Mailing Address _______________________________________________________________________________________ ______________________________________________________________________________________________________________ (City) (State) (Zip + 4)
Home Telephone Number (_____)___________________
e-mail _____________________________
__________________________________________
(Signature)
_______________________
(Date)
IMPORTANT INFORMATION: If you desire an inactive pocket card, return this completed form and fee of seven dollars and fifty cents ($7.50). A new pocket card will be issued to you and mailed to the above home mailing address.
THIS SPACE FOR OREC USE ONLY
OREC RW4503a Change of Home Address (Rev. 02/02)