Georgia Real Estate Appraisers Board Page 2
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5229 Peachtree Street NE
Suite 1000 - International Tower
Georgia Real Estate Commission
Atlanta, GA 30303-1605
Phone: 404-656-3916
Georgia Real Estate Appraisers Board
Fax: 404-656-6650
Email: grecmail@grec.state.ga.us
Section B
Controlling Person Information
First
Middle
Last
Suffix
Name:
Name:
Name:
Birth date
Male
Female
SSN:
(
mm/dd/yyyy)
E-mail:
Residence Address:
City:
State:
Zip Code:
County:
Business Phone Number:
Mailing Address:
Zip Code:
State:
City:
County:
Alternate Phone Number:
NOTIFICATION OF REQUEST FOR SOCIAL SECURITY ACCOUNT NUMBER (SSAN)
The Georgia Real Estate Commission and Appraisers Board will not release your SSAN to any third party except as required by law.
Section C
Surety Bond
Each Appraisal Management Company must provide proof of financial responsibility in the form of :
A Surety Bond of not less than $20,000 coverage.
PROVIDE THE FOLLOWING INFORMATION FOR THE SURETY BOND:
Institution Name:
Bond Number:
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GREAB
(11-2014)
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