Certified Appraiser Testing Application
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1
2APPLICATION FOR APPRAISER TESTING
Louisiana Real Estate Appraisers Board
Post Office Box 14785
Baton Rouge, LA 70898-4785
225/925-1923 or 1-800-821-4529 (Extension 241)
INITIAL LICENSE FEE - $245.00
The Board may decline to accept this application unless all requested information is provided and proper payment is
enclosed. Payment may be in the form of a personal check, payable to the Louisiana Real Estate Appraisers Board
(LREAB). The license fee is NOT refundable once the application has been accepted for filing by the Board.
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Type of License You Are Applying For:
Certified Residential
Certified General
(Copies of course completion certificates and college diploma MUST accompany this application.)
1. Full Legal Name: ________________________________
__________________________
______________
(Last)
(First)
(Middle)
2. Social Security Number: ____________________________
3. Date of Birth: _________________________
4. If not a United States Citizen, please furnish your Alien Registration Number: ____________________________
5. Permanent Mailing Address and Contact Information:
__________________________________________________________________________________________
Street Address or P.O. Box Number
Apt. or Suite Number
__________________________________________________________________________________________
City
State
Zip Code
Telephone Number: ___________________________
Cell Phone Number: __________________________
Fax Number: __________________________
Email Address: _____________________________________
6. Provide information relative to each real estate appraiser license that you currently hold, or held in the last five
years.
License Classification
License No.
Jurisdiction
Issue Date
Exp. Date
______________________
____________
______________
___________
____________
7. Have you ever had a real estate salesperson, broker, or appraiser license suspended, canceled or revoked;
surrendered a license pending disciplinary action; or had an application for such denied in Louisiana or any other
state?
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Yes
No
If “Yes”, include a detailed letter of explanation with this application.
8. Are any complaints, disciplinary hearings, or investigations pending against any licenses you currently hold?
□
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Yes
No
If “Yes”, include a detailed letter of explanation with this application.
9. Have you ever been convicted, pled guilty or nolo contendere to the crimes of forgery, embezzlement, obtaining
money under false pretenses, larceny, extortion, conspiracy to defraud, theft, or any crime of moral turpitude?
□
□
Yes
No
If “Yes”, include a detailed letter of explanation with this application.
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