State Form 46467 - Application For Reactivation Of Inactive Real Estate Appraiser License

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Indiana Professional Licensing Agency

APPLICATION FOR REACTIVATION OF INACTIVE

302 West Washington Street, Room E034

REAL ESTATE APPRAISER LICENSE

Indianapolis, Indiana 46204-2700

State Form 46467 (R / 8-99)

INSTRUCTIONS: Please complete this form in its entirety and mail to the above address.

No Fee

Name of applicant

Address (number and street, city, state, ZIP code)

License number

In order to reactivate an inactive license, you must have obtained twenty-eight (28) classroom hours of qualifying continuing education within the two (2) years

preceding the filing of this application. Fifteen (15) hours over three (3) renewal periods shall cover the Uniform Standards of Professional Appraisal Practice

and must include passing of an examination concerning the standards. If you are activating within a third renewal period cycle, you must complete the fifteen

(15) hours of Uniform Standards of Professional Appraisal Practice and examination as part of the twenty-eight (28) hours required to activate.

NAME OF COURSE

CLASSROOM HOURS

TOTAL

NOTARY CERTIFICATE (SWORN OATH)

STATE OF ________________________________________

}

COUNTY OF ______________________________________

SS:

I, ________________________________________________________________________, having been duly sworn on oath, say that I am the

above named applicant, that I have personally prepared the foregoing application, and that the same is true to the best of my knowledge and belief.

Signature of applicant