REQUEST FOR CERTIFICATE OF LICENSE HISTORY
[Pages:1]12/2019
STATE REAL ESTATE COMMISSION PO Box 2649 Harrisburg PA 17105-2649
Phone Number: 717-783-3658 dos.estate
Overnight Mailing Address: State Real Estate Commission
2601 N Third Street Harrisburg PA 17110
REQUEST FOR CERTIFICATE OF LICENSE HISTORY
The Certificate of License History includes the original date of licensure, current status, how the license was obtained, and if any disciplinary action exists. It also indicates the education credits and test scores needed for your license classification.
Return this completed form along with a $40.00 check or money order payable to the Commonwealth of Pennsylvania." NOTE: There is a $20.00 charge for all return checks regardless of the reason for
non-payment.
LICENSEE'S INFORMATION
Licensee's Last Name:
First:
Middle:
License #
Social Security #
Street:
Licensee's Address: City:
State:
Zip:
Select your delivery method below. Note ? You can only select one delivery method per request.
Mailed
MAILING INFORMATION: Provide the mailing address for the location where you wish this mailed. Name:
Street:
Mailing Address: City:
State:
Zip:
Emailed
EMAILING INFORMATION: PLEASE NOTE: E-MAILED COPIES OF YOUR CERTIFICATE OF LICENSE HISTORY DO NOT INCLUDE A RAISED SEAL ON THE DOCUMENT. IF YOU REQUIRE A RAISED SEAL, YOU MUST REQUEST THE DOCUMENT TO BE RECEIVED BY MAIL (ABOVE).
Provide the name and email address of the party you wish this emailed. Recipient's Name:
Recipient's Email:
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- state by state listing of professional licensing agencies
- getting started with the teacher information management
- instuctions for viewing online certification application
- fingerprinting service information pennsylvania
- request for certificate of license history
- effective january 1 2020 505 2 04 induction certificate
- act 48 faq continuing professional education requirements
- cte teacher certification
- types of teaching authorizations and certifications
- how do i get my ppid
Related searches
- request for hearing department of educat
- request for hearing department of education
- us department of education request for hearing
- request for renewal of contract template
- department of education request for hearing
- study guide for fdny certificate of fitness
- request death certificate pa
- request death certificate online
- 2020 certificate of status request form scam
- request birth certificate florida online
- request for letter of recommendation
- virginia application for certificate of title