Form Re-620-170 - Application For Certification As A Real Estate Appraiser

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Mail completed application and fees to:
STATE OF WASHINGTON
STATE OF WASHINGTON
Department of
Department of
Business and Professions Division
Real Estate Appraiser Section
P.O. Box 9021
Olympia, WA 98507-9021
APPLICATION FOR CERTIFICATION AS A
FOR VALIDATION ONLY
REAL ESTATE APPRAISER
Fee $196.00 payable to Washington State Treasurer
Check one only:
Certified General
Certified Residential
State Licensed
Please type or print clearly
Instructions
Individuals may attain Licensure/Certification to practice
Out-of-state licensees must include
real estate appraisal in the State of Washington by meeting
• A notarized Consent to Service (RE-620-177)
the requirements set forth in RCW 18.140 and WAC
• An official license history submitted directly to this office
308.125.
by the state-of-licensure's regulatory agency
They must also
• Complete, sign, and submit this application
All fees are non-refundable. Applications will be kept on
• Submit official college transcripts or copies of course
file for a period of six months for the applicant to correct any
certificates together with confirmation of examination
discrepancies other than the appraisal experience log.
passage
• Submit the required fee
Applicant information
APPLICANT'S NAME (last, first, middle)
DATE OF BIRTH
MAILING ADDRESS
CITY
STATE
ZIP
COUNTY
BUSINESS NAME
BUSINESS ADDRESS (current physical place of business is required)
CITY
STATE
ZIP
COUNTY
TELEPHONE NUMBER (during normal business hours)
SOCIAL SECURITY NUMBER (required per RCW 26.23.150)
SEX (M or F)
Are you currently licensed/certified as a real estate appraiser in Washington state?
Yes
No
IF YES, INSERT LICENSE/CERTIFICATE NUMBER
REFERENCE NUMBER
Have you ever applied for licensure/certification as a real estate appraiser in Washington state?
Yes
No
Are you currently licensed in Washington state as a real estate salesperson, broker or associate broker, or escrow agent?
Yes
No
IF YES, FULL NAME UNDER WHICH YOU ARE LICENSED (as it appears on your license)
LICENSE NUMBER
REFERENCE NUMBER
The Department of Licensing has a policy of providing equal access to its services. If
you need special accommodation, please call (360) 753-1062 or TDD (360) 753-1966.
RE-620-170 RE APPRAISER APP. (R/1/99)M/W Page 1 of 5

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