License iD number
(Real Estate Applicant / Licensee)
RE 234 (Rev. 11/16)
This form is to be used by a non-resident real estate license applicant or licensee.
knoW all perSonS BY THeSe preSenTS:
I, ____________________________________________, am a non-resident of the State of California, to wit a resident of the State
of __________________________, and I am either an applicant before the real estate Commissioner of the State of California for a
California real estate license or currently have a valid California real estate license or license rights associated herewith, and hereby certify:
1. Complete “a” or “b.”
If engaging in activities requiring a California real estate license, the complete address of applicant’s or licensee’s place of
business in the State of California is:
b. If not engaging in activities requiring a California real estate license, the complete mailing address of applicant or licensee
2. That the applicant or licensee hereby irrevocably consents that if in any action commenced against him in the State of California
personal service of process upon him cannot be made in this State after the exercise of due diligence, a valid service may
thereupon be made upon him by delivering the process to the Bureau of real estate of the State of California.
3. That the Bureau of real estate of the State of California may mail a copy of any such process to applicant at the following
address or at the applicants mailing address of record, filed pursuant to Regulation 2715, Title 10, Chapter 6, California Code
In WITneSS WHereoF, applicant or licensee has subscribed his/her name hereto this _______________________
day of ____________________20_____, at ________________________________________________________________________
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
on this _______________________________ before me __________________________________________________,
(insert name and title of the officer)
personally appeared _______________________________________ who proved to me on the basis of satisfactory evidence to
be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the
same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity
upon behalf of which the person(s) acted, executed the instrument.
I certify under penalTY oF perjurY under the laws of the
State of California that the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Signature of Notary Public