Form Re-620-004 - Application For Real Estate Salesperson/associate Broker/ Branch Manager - State Of Washington
Download a blank fillable Form Re-620-004 - Application For Real Estate Salesperson/associate Broker/ Branch Manager - State Of Washington in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Re-620-004 - Application For Real Estate Salesperson/associate Broker/ Branch Manager - State Of Washington with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2REAL ESTATE LICENSING
P.O. BOX 9048
APPLICATION FOR REAL ESTATE
OLYMPIA, WA 98507-9048
(360) 664-6488 or (360) 664-6500
FAX (360) 586-0998
SALESPERSON/ASSOCIATE BROKER/
BRANCH MANAGER
Click Here to Start, Then Tab From Field to Field
Check the appropriate box:
Make remittance payable to State Treasurer.
First Assoc. Broker/Branch Mgr . $210.00
Send application with your remittance to:
First Salesperson ........................ $146.25
Department of Licensing
Transfer/Reactivation/Change in
PO Box 9048
Olympia, WA 98507-9048
Status/Class* ................................ $26.50
Please type or print clearly
Applicant Information
-
If application information is incomplete, the application will not be processed.
*
Applicant's Name
Social Security Number
Applicant's Date of Birth
Employing Company Name
Date of Examination
Employing Company Address (Number, Street, and PO Box if applicable)
Company Telephone No.
(
)
City
State
Zip
County
Applicant's Mailing Address (Number, Street, and PO Box if applicable)
Applicant's Telephone No.
(
)
City
State
Zip
County
Please respond to the following questions:
1. With the exception of motor vehicle violations, have you ever been convicted of a crime, felony, or
misdemeanor by this state, any other state, the federal government, or any other jurisdiction within the
Yes
No
past ten years? (NOTE: If you have been convicted of a crime, you will be subjected to an investigation,
and you may be denied a license.)
2. Is there a criminal complaint or accusation, or other information presently pending against you, or are you
Yes
No
under indictment in this state, any other state, by the federal government, or by any other jurisdiction?
3. Has any application for a professional or occupational license or permit made by you ever been denied, or
has a license or permit issued to you ever been suspended, revoked, censured, or fined, in this state or
Yes
No
any other jurisdiction?
4. Have you ever had a civil court order, verdict, or judgment entered against you in any court of competent
Yes
No
jurisdiction in which the subject matter involved any real estate or business related activity?
Yes
No
5. Are you currently required to register as a sex offender in this state or any other state? If yes,
state
county
(Attach letter of explanation for any affirmative answer(s) to the questions above.)
If applying for a Branch Manager's license: Do you agree to personally manage the branch office indicated
Yes
No
on this application?
*
State law, RCW 26.23.150, requires you to furnish your Social Security Number when applying for this license. If this
application is for a business that is a sole proprietorship, the proprietor must furnish his/her Social Sercurity Number.
Resident aliens, without a Social Security Number, must furnish their Individual Tax Indentification Number.
I certify that the above information is true and correct. Failure to comply with any provision of the Real Estate Licensing
Act or any rule or regulation promulgated thereunder may result in suspension or revocation of license.
X
Applicant's Signature ____________________________________________________ Date ___________________
X
Broker's Signature ______________________________________________________
Broker's Name (typed or printed) ___________________________________________
Upon filing, this application becomes a public record and is subject to public disclosure provisions pursuant to RCW 42.17
For Office Use Only
1
Prog
Tran
Prof
Pic No.
Exp. Date
Stat.
Class
Bill
Split
Rev
Cic No.
Pointer
Cert Date
Release
LA Date
The Department of Licensing has a policy of providing equal access to its services. If
you need special accommodation, please call (360)664-6500 or TTY (360)664-8885.
RE-620-004 APP FOR RE LIC (R/2/03)FM/W Page 1 of 2
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal