TEXAS DEPARTMENT OF SAVINGS AND MORTGAGE LENDING
2601 North Lamar, Suite 201, Austin, Texas 78705
Office: (512) 475-1350 Fax: (512) 475-1360
INACTIVATE LICENSE FORM
THIS FORM SHOULD BE USED BY MORTGAGE BROKERS, LOAN OFFICERS, AND
ENTITY MORTGAGE BROKERS TO INACTIVE NON-EXPIRED LICENSES
NOTE: Only non-expired licenses may be placed on inactive status. A mortgage broker placed on inactive status
is still subject to possible inspection/examination and must continue to file an annual report with the department. In
addition, all licensees on inactive status must continue to seek the necessary continuing education hours during the
term of their license in order to renew the license prior to expiration. If the license is not renewed by the date of
expiration, the license will expire. To reactivate a license prior to renewal, a mortgage broker or an entity mortgage
broker would complete a Mortgage Broker Change Form and a loan officer would complete a Loan Officer Change
Form and a Loan Officer Sponsor Certification Form, and submit them to the department with the appropriate fee
for processing. Be advised the process to effect the submitted change will take approximately 10 working days.
Part I. Check one of the boxes below to identify your request.
[ ] Inactivate Mortgage Broker [ ] Inactivate Loan Officer License [ ] Inactivate Entity Mortgage
License (No Fee Required) Broker License
(No Fee Required) (No Fee Required)
Part II. Licensee Information.
Part III. Signature.
Mortgage Broker Signature: Date:
Loan Officer Signature: Date:
Designated Representative Name:
DR Signature: Date: