Georgia Real Estate Appraisers Board Page 5
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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
Part (2)
You must supply the Name, Address and Contact Information for any individual or any corporation, limited liability company,
partnership, or other business entity that owns 5 percent or more of the Appraisal Management Company applying for this
registration.
List Names and Address and Contact Information ( attach additional pages if necessary)
Please Note:
(1) For an "Individual Owner with a direct ownership interest of more than 50% of an Appraisal Management Company" attach a
Georgia Criminal Information Center (GCIC) report if you are a Georgia resident. If you are not a resident of Georgia, attach a
state wide criminal background report from your state of residency. This report must not be more than 60 days old. A report from a
party other than a law enforcement agency is not acceptable. Any incident listed on the report must receive clearance. In addition,
you must disclose any conviction, nolo contendere plea, or first offender sentence not reflected on the report.
(2) If as an "Individual Owner with a direct ownership interest of more that 50% of an Appraisal Management Company" you are
disclosing a conviction, nolo contendere plea, or first offender sentence that is not already on file with us, you must also include the
required documents noted in Section D of this application.
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(11-2014)
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