Reciprocal License Application (Page 2 of 2) in pdf

Reciprocal License Application Page 2

REAL ESTATE APPRAISER - RECIPROCAL LICENSE APPLICATION Page 2 of 2

8. Have you ever had an application for a real estate appraiser, salesperson, or broker license rejected in any

state?

□

Yes

Attach a detailed letter of explanation for any “yes” answer.

9. Have you ever had a real estate appraiser, salesperson, or broker license censured, suspended, or revoked?

□

Yes

Attach a detailed letter of explanation for any “yes” answer.

CERTIFICATION

I hereby certify that all information provided herein is true and correct. I agree to furnish additional information or

documentation as may be deemed necessary by the Louisiana Real Estate Appraisers Board. I acknowledge that

my application for licensing by reciprocity may be rejected for cause and that the license I may obtain may be

revoked for supplying false or misleading information to the board. I agree to comply with the Louisiana Real

Estate Appraisers Law and the Rules and Regulations of the Board. I will perform all appraisals in compliance with

the Uniform Standards of professional Appraisal Practice (USPAP).

IRREVOCABLE CONSENT TO SERVICE OF PROCESS AND POWER OF ATTORNEY

I do hereby irrevocably make, constitute, and appoint the Executive Director of the Louisiana Real Estate

Appraisers Board, and his successors in office, my true and lawful attorney-in-fact, and in the State of Louisiana,

upon whom all process of law concerning me in any legal action or proceeding may be served, subject to and in

accordance with all laws of the State of Louisiana and all amendments thereto, and I do hereby specifically agree

that in any and all such legal processes of law, which may be served upon my attorney-in-fact, shall be deemed

served upon me personally, and that all such processes of law served upon my attorney-in-fact shall have the same

effect as if I were a resident of the State of Louisiana and have been personally served with such process of law.

This Irrevocable Consent of Service is made in compliance with Section 3401.A of the Louisiana Real Estate

Appraisers Law.

Signature of Applicant: _____________________________________________________ Date: ________________

COUNTY OF ___________________________

STATE OF ___________________________

SWORN TO AND SUBSCRIBED before me by _______________________________________ on this _____ day of

_______________________, 20_____.

(SEAL)

_______________________________________

Notary Public

REAB/REC Rev. 05/2013

Reciprocal License Application Page 2