Initial Real Estate Salesperson License Application

Initial Real Estate Salesperson License Application – Part A – Page 3 of 3

16. Have you ever had a salesperson or broker license denied, censured, suspended, or revoked in

Louisiana or any other state? If yes, furnish a letter of detail with this application.

Yes

17. Have you ever been convicted, pled guilty or nolo contendere to (a) the crimes of forgery,

embezzlement, obtaining money under false pretenses, larceny, extortion, conspiracy to defraud, theft, or

any crime of moral turpitude, or (b) any felony crime in a court of competent jurisdiction?

Yes

No If yes, furnish a letter of detail with this application.

EDUCATION:

18. Name the institution and the city and state from which your high school diploma or equivalency

certificate was received:

Name:

__________________________________________________________________________________

Location: _________________________________________________________________________________

19. Attach proof (certificates or transcripts) that you have completed the 90-hour prerequisite course work

required for this license.

IRREVOCABLE CONSENT TO SERVICE OF PROCESS AND POWER OF ATTORNEY FOR

RECIPROCAL AND NON-RESIDENT APPLICANTS ONLY: I do hereby irrevocably make, constitute,

and appoint the Executive Director of the Louisiana Real Estate Commission, and any successors in

office, my true and lawful attorney-in-fact, and in the State of Louisiana, upon whom all process of law

concerning me in any legal action or proceeding may be served, subject to and in accordance with all

laws of the State of Louisiana and all amendments thereto, and I do hereby specifically agree that in any

and all such legal processes of law, which may be served upon my attorney-in-fact, shall be deemed

served upon me personally, and that all such processes of law served upon my attorney-in-fact shall have

the same effect as if I were a resident of the State of Louisiana and have been personally served with

such process of law.

CERTIFICATION AND ACKNOWLEDGMENT FOR ALL APPLICANTS: I attest that I have knowledge of

and understand the provisions of the Fair Housing Act of 1968, the Louisiana Equal Housing Opportunity

Act, and any amendments thereto, and that I will neither induce nor attempt to induce any person to sell

or rent any dwelling by representation regarding the entry or prospective entry into an area, subdivision or

neighborhood of a person or persons of a particular race, color, religion or national origin. I hereby

acknowledge the forfeiture of all fees filed with my application for a Louisiana real estate license in the

event that I do not obtain the license for which I have applied. Further, if this application is acted upon

favorably, I agree to comply with all the laws embodied in Title 37, Chapter 17, Louisiana Revised

Statutes of 1950, and amendatory acts, and the Rules and Regulations of the Louisiana Real Estate

Commission. I hereby certify that all the information provided herein is true and correct and the Louisiana

Real Estate Commission may rely on its truthfulness in considering this application.

_______________________________________________

____________________

Signature of Applicant

Date

IMPORTANT: Remember to order your criminal background check and to include all requested

attachments. Failure to do so will prolong the application process and the issuance of the license for

which you have applied. If you do not have a sponsoring broker at the time of application for testing, only

Part A-Initial Real Estate Salesperson License Application should be submitted. Upon passage of the

examination, you will have 90 days to secure a sponsoring broker and submit Part B-Initial Real Estate

Salesperson Sponsorship Affidavit to complete the licensing process. Upon passage of the examination,

but prior to the issuance of a license, you must show proof of Errors and Omissions insurance coverage.

A license will not be issued until such proof is provided. Please notify the LREC of any disability which

may require special accommodations, auxiliary aids, or services, with regard to the application process.

InitSales Rev. 06/15/2014

Initial Real Estate Salesperson License Application - Part A Page 3

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