Background History Form
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Texas Real Estate Commission
P.O. Box 12188
Austin, Texas 78711-2188
(512) 936-3000
BACKGROUND HISTORY FORM
NOTE: You may type information into this form and it will display, but you will need to print and mail the form along with copies of
documents to TREC when completed. Information entered into this form can only be saved if you are able to print and save the form
as a PDF.
The Commission must review your background in connection with a Moral Character Determination form (MCD) or certain "Yes" answers
given on your application before a decision on your MCD or application can be made. Please complete Sections 1, 2 and 3 and any other
applicable section. Be sure to provide complete, legible copies of any documentation needed. Be specific and provide exact details. Attach
a separate form for each additional license, judgment, or crime that you need to report. Attach additional pages for explanations that
require more space.
1.Full Name:
SSN#
Last
First
Middle
2. Address and Contact Information: (Post Office Box may be used)
Number, Street and Apt. No. or P.O. Box
City
State
Zip Code
Area Code
Phone Number
Date of Birth:
E-mail Address
Month
Day
Year
3. EMPLOYMENT HISTORY: Provide employment history for the last five (5) years to the present date.
Explain any periods of
unemployment for more than thirty (30) days. If additional space is needed, attach a separate sheet of paper to complete your answer.
FROM
TO
Employer
City, State
Position/Duties
Month/ Year
Month/ Year
4. OUT OF STATE REAL ESTATE LICENSE:
Issuing State:
Date Issued:
Status:
Active
Inactive
Expired
Other
Action Taken on License (if applicable):
Revoked
Surrendered
Suspended
Terminated
Other
Effective Date of Action:
Explanation of circumstances leading to any action taken:
Documentation Needed: Submit license history signed by state licensing agency.
This document is available on the TREC website at
Page 1 of 3
BH-2 (Background History Form) (06/20/2016)
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