Initial Real Estate Salesperson License Application

LOUISIANA REAL ESTATE COMMISSION

Post Office Box 14785

Baton Rouge, LA 70898-4785

(225) 925-1923 or (800) 821-4529 (LA only)

Initial Real Estate Salesperson License Application – Part A

Complete this form to apply for an initial Resident, Non-Resident, or Reciprocal Real Estate Salesperson

License. Read the instructions carefully, as certain application requirements may differ for each license

type. Personal checks, company checks, cashier’s checks, and money orders are accepted. Make fees

payable to the Louisiana Real Estate Commission. Please do not send cash through the mail.

Initial license fee……………………………...

$45.00

FOR LREC USE ONLY

Research and Education Fund fee…………

$10.00

Recovery Fund fee……………………..........

$10.00

Application Processing fee………………….

$25.00

TOTAL.......................................................

$90.00

Errors and Omissions Insurance premiums that may be due upon submission of this application are not included in the total amount

listed.

TYPE OF LICENSE FOR WHICH YOU ARE APPLYING: Select one

Louisiana Resident

Reciprocal Non-resident (Active resident licensee in AL, AR, CO, GA, IA, MS, NM, OK,

PA)

Non-resident (Active resident licensee in a state other than Louisiana or the above reciprocal states)

PERSONAL INFORMATION: Complete all applicable sections

1. Legal first name and middle initial

__________________________________________________

2. Legal last name (and suffix, if any)

__________________________________________________

Licensees are restricted from advertising in any name other than the identical name that appears on their license. If

you are known by a name other than the legal name listed above, such as a nickname or your middle name, and you

wish to be licensed in that name, you must indicate the specific name, including any suffix, as you wish for it to

First Middle “Nickname” Last

“Nickname” Last

First, Middle,

appear on your license and in all advertising. (Ex:

Last, Jr. or other variations of your choice

)

3. State your name exactly as you wish for it to appear on your license:

___________________________________________________________________________________________

In accordance with LA R.S. 37:23, you are required to provide your social security number on all applications for a

state license or certificate. The law charges the LREC with the responsibility for maintaining the confidentiality of this

information. The LREC is prohibited from releasing any social security number, unless requested to disclose it to the

agency charged with implementing a program of family support, as specified in LA R.S. 46:236.1.1 et seq.

4. Enter your social security number here

A United States Permanent Resident Card (Form I-551), commonly known as an Alien Registration Card or Green

Card, is issued as proof of a non-citizen’s lawful permanent resident status in the United States. An individual with a

valid Form I-551 has the right to live and work permanently in the United States. If you are a permanent resident age

18 or older, you are required to have a valid green card in your possession at all times. See Immigration and

Nationality Act, INA: Act 264 – Forms and Procedures [8 U.S.C. 1304]. Skip No. 5 if it is not applicable to you.

5. Enter your alien registration number here

InitSales Rev. 06/15/2014

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Initial Real Estate Salesperson License Application - Part A

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