Change Of Employer Application - Standard Or Reciprocal Licensees (Page 2 of 4) in pdf

Change Of Employer Application - Standard Or Reciprocal Licensees Page 2

56-SPOA 2102 (6/13)

9. Question #18 – Conviction includes a finding or verdict of guilt, an admission of guilt, a plea of

nolo contendere or receiving probation without verdict, disposition in lieu of trial or an

Accelerated Rehabilitation Disposition in the disposition of criminal charges. Only felony and

misdemeanor convictions must be reported to the Commission. If a conviction has occurred in

any state that has not yet been reported to the Commission, submit all documentation about

the conviction.

10. Employer Certification – The employer certification must be signed by the broker or broker of

record if the employing broker is a corporation or partnership.

11. APPLICATION CHECKLIST

Attach the following documents to this application:

Check or money order made payable to the Commonwealth of Pennsylvania in the

amount of $20.00.

All fees are NON-REFUNDABLE regardless of whether a license is issued. A $20.00

processing fee will be charged for any returned unpaid check.

Disciplinary Action documents (if applicable)

Name Change documents (if applicable)

Criminal Conviction documents (if applicable)

PROCESSING INFORMATION

Licenses are mailed to the employing broker’s main office address.

DELAYS may occur in the processing of this application if submitted between March 1 and June 30

of even numbered years.

You should maintain a copy of this application until a new license has been issued.

Change Of Employer Application - Standard Or Reciprocal Licensees Page 2