Appraisal Management Company - Initial License Application
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3Louisiana Real Estate Appraisers Board
9071 Interline Avenue
Post Office Box 14785
Baton Rouge, LA 70898-4785
225-925-1923 or 800-821-4529 (LA only)
APPRAISAL MANAGEMENT COMPANY
Initial License Application
This application is prescribed in accordance with LA R.S. 37:3415.1, et seq. Each question must be
answered thoroughly and completely. Failure to disclose pertinent information may result in the delay
or denial of your license. See the prorated fee schedule below. Make fee payable to the Louisiana Real
Estate Appraisers Board. Company checks, personal checks, certified checks, and money orders are
accepted. Please do not send cash via mail.
Jan $1500.00
Feb $1375.00 Mar $1250.00 Apr $1125.00
May $1000.00 Jun $875.00
Jul $750.00
Aug $625.00
Sep $500.00
Oct $375.00
Nov $250.00
Dec $125.00
PLEASE TYPE OR PRINT
1. Name of the entity seeking a license ____________________________________________________
2. Mailing address
____________________________________________________
3. City, state, zip
____________________________________________________
4. Physical address, if different from the mailing address listed above
____________________________________________________
5. City, state, zip
____________________________________________________
6. Phone number
(
) _______________________
7. List the name, address, and contact information for any individual, corporation, partnership, or other
business entity that has any ownership interest in the entity seeking a license. Attach a separate
sheet, if necessary.
a.
Name
____________________________________________________
Address
____________________________________________________
City, state, zip
____________________________________________________
Phone number
(
) _______________________
b.
Name
____________________________________________________
Address
____________________________________________________
City, state, zip
____________________________________________________
Phone number
(
) _______________________
c.
Name
____________________________________________________
Address
____________________________________________________
City, state, zip
____________________________________________________
Phone number
(
) _______________________
AMC Rev. 03/14
Page 1 of 3
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