C-73.1, r. 2 - By-law of the Association des courtiers et agents immobiliers du Québec

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23. A person referred to in section 22 shall also send with his application the following information and documents, accompanied by a solemn affirmation attesting to their accuracy:
(1)  the information and documents provided for in section 19;
(2)  the category and number of his certificate or certificates for a market intermediary in insurance;
(3)  the name under which he carries on the activity of market intermediary in insurance;
(4)  the name of the market intermediary in insurance or of the insurer that employs him; and
(5)  a copy of his certificate or certificates for a market intermediary in insurance.
O.C. 1865-93, s. 23.