Fillable BROKER LICENSE $160 APPLICATION capacity of a real (Idaho Real Estate Commission)

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BROKER LICENSE $160 APPLICATION capacity of a real (Idaho Real Estate Commission)

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REE-041-11
Rev. 07/2020
IREC use only
License #:
__________________________
Receipt #
: __________________________
Approved:
__________________________
575 E. Parkcenter Blvd., Suite 180
Boise, Idaho 83706
O ce: (208) 334-3285
irec.idaho.gov
BROKER LICENSE
APPLICATION
$160
$160
INSTRUCTIONS: Submit this original, completed application form with the fee and ALL required
attachments. Applications that are illegible, incomplete, or missing the fee or required
attachments will be immediately returned without processing.
Applications that are faxed/emailed will not be accepted.
You are not licensed until IREC approves your license application. It is unlawful for you to engage in the business or act in the
capacity of a real estate licensee in Idaho without  rst obtaining a license. Allow 10 business days to process your completed
application.
NOTE: Applications are processed in the order received. Updates on the status of license applications will NOT be given
over the phone. When your name and license number appear in the License Lookup on the IREC website, your license
has been approved.
Page 1 of 3
1. PERSONAL INFORMATION
Social Security Number Date of Birth Maiden name (or any other names used)
Full legal name - must exactly match the name on your legal ID Nickname (if used)
Home Phone Cell Phone Email address
Home Address (number, street, apt.)
City County State Zip Code
Home Mailing Address (number, street, apt.), if diff erent from above
City County State Zip Code
2. HIGH SCHOOL GRADUATION (Provide a copy of your high school diploma or equivalency certifi cate. The Commission
will also accept a college or university diploma, an o cial high school transcript showing a graduation date, or an o cial
college transcript showing enrollment in an accredited degree program.)
Name of High School or Equivalent Location (city & state) Date of High School Graduation
3. RECORD OF LICENSURE Do you presently hold an active sales or broker level license in another state? NO YES
If so, attach a current (less than 6 months old) original certifi ed license history from that state.
4. List all states or jurisdictions, including Idaho, in which you currently hold or have ever held a real estate license or other
professional or occupational license, if applicable.
State or Jurisdiction Type of License Held Dates of Licensure (from/to)
_______________________________ _______________________________ _______________________________
_______________________________ _______________________________ _______________________________
5. Have you ever had a real estate or other professional or occupational license revoked, suspended, or surrendered,
or the renewal refused, for a disciplinary violation involving fraud, misrepresentation or dishonest or dishonorable dealing,
in Idaho or any other jurisdiction?
NO YES
(If you answered “yes”, state the type of license, jurisdiction, date, disposition, and any other pertinent information on a
separate page and attach it to this application.)
EXPERIENCE VERIFICATION (If actively licensed as a broker in another state, you do not need to complete this section.)
Under the Idaho Real Estate License Law, an applicant for a broker’s license must have at least two (2) years full time,
active experience as a licensed real estate salesperson within ve (5) years immediately preceding the application. The
current commission-approved experience requirement is 15 completed sales and/or listings. The completed sales and/or
closed listing must result in at least $2 million in total volume.
If an applicant cannot meet these experience requirements, he/she may make a written request for special consideration
based on educational background or experience in related or aliated business activities. Specic documentation is required to
request special consideration. Please contact IREC for assistance if you do not meet the above experience requirements.
This section MUST be completed by the broker(s) with whom the applicant was associated with showing at least two
(2) years full time active experience in the manner described above as a licensed salesperson. (Copy this form as
needed.)
A. Applicant’s name
B. Applicant was licensed with my oce continuously from / / to / /
month day year month day year
C. Description of Applicant’s experience as a real estate licensee in my oce:
Applicant worked (check one) Full time Part time
Applicant devoted an average of: hours per week to this work.
Total number of completed listings: Dollar volume of completed listings: $
Total number of completed sales: Dollar volume of completed sales: $
Other real estate activity, if any (explain)
D. AFFIDAVIT At all times relevant, I was a licensed real estate broker in the State of ,
and the foregoing statements are true and correct to the best of my knowledge, information, and belief.
Name of designated broker (please print)
Brokerage name Brokerage phone
Brokerage street address
City State Zip
_________________________________________________________
Signature of Designated Broker
NOTARY IS REQUIRED
State of )
) ss.
County of )
Signed (or attested) before me on ______________________________ by _______________________________________________.
Date Name of Individual (designated broker)
___________________________________________________
Signature of Notary notary
seal
___________________________________________________
My Commission Expires
REE-041-11 Rev 07/2020 Page 2 of 3
6. PRIOR TO SUBMITTING THIS APPLICATION, YOU MUST BE ABLE TO ANSWER “YES” TO ALL OF THE FOLLOWING:
____ I have completed all broker prelicense education within the previous 3 years...........................................................................
____ I have completed the BCOO or Brokerage Management course within the previous 3 years (DB applicants only)..................
____ My ngerprints have been approved (RES-OK) within the last 6 months..................................................................................
____ I have passed my license exam(s) within the previous 12 months.............................................................................................
7. PLEASE VERIFY YOU HAVE INCLUDED THE FOLLOWING REQUIRED ATTACHMENTS:
____ $160 license fee (check or credit card authorization form).......................................................................................................
____ Copy of high school diploma, equivalency certicate, college or university diploma or ocial high school or
college transcript (part 2)..........................................................................................................................................................
____ Current (less than 6 months old) certied license history from your state of licensure (if applicable).......................................
____ Explanation of license disciplinary actions, if applicable (part 5)..............................................................................................
____ Copy of document showing legal presence in US (one of the following) (part 8):
* Idaho drivers license or identication card
* Valid drivers license or identication document with photo from another state or US territory
* Native American tribal document
* Valid US passport or VISA ..............................................................................................................................................
DESIGNATED BROKER OR BRANCH OFFICE MANAGER APPLICANTS ONLY:
New Oce:
____ Completed application for your chosen type of business - include all attachments and any related fees................................
OR
Existing Oce:
____ Notice of Broker Change form (REE-043) adding you to the company - include all required attachments..............................
8. Are you a military service member veteran? NO YES
9. Are you or your spouse on active military duty? NO YES (Fill out form REE-010 and attach)
10. I ATTEST, UNDER PENALTY OF PERJURY, THAT: (choose one)
I am a United States citizen; OR I am a legal permanent resident of the United States; OR
I am otherwise lawfully present in the United States; OR None of the above.
11. I hereby appoint the Executive Director of the Idaho Real Estate Commission to act as my agent upon whom all judicial and other
process or legal notices directed to me may be served. I hereby consent that any lawful process against me that is served upon the
Executive Director shall be of the same legal force and validity as if served upon me and that this authority shall continue in force so
long as any liability remains outstanding in the state of Idaho. (Idaho Code 54-2012(1)(k))
12. I acknowledge it is my responsibility to provide written notice to the Idaho Real Estate Commission of any change of my
personal name, address of personal residence, or personal telephone number within ten (10) days of the change. (Idaho Code
54-2018(9))
13. I certify that the answers appearing hereon are true and correct to the best of my knowledge and belief. I understand that my application
may be denied, or my license inactivated, expired, terminated, suspended or revoked, and/or I may be subject to disciplinary action, for
the use of fraud, deception, misrepresentation, misstatement or omission or any unlawful means in applying for or securing a license
to act as a real estate broker in the State of Idaho (Idaho Code 54-2019 and 54-2060(4)).
____________________________________________________
Applicant Signature
NOTARY IS REQUIRED
State of )
) ss.
County of )
Signed (or attested) before me on ______________________________ by _______________________________________________.
Date Name of Individual (applicant)
___________________________________________________
Signature of Notary notary
seal
___________________________________________________
My Commission Expires
NOTICE: Because of rising costs associated with issuing a refund, it is the policy of IREC to refund overpayments of under $25 only if requested in writing within 30 days of IREC
receipt of the overpayment. Overpayments of $25 or more will be automatically refunded. There is a $20 fee assessed for each check returned to IREC for insucient funds.
REE-041-11 Rev. 07/2020 Page 3 of 3
IREC use
ONLY
IREC use
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BROKER LICENSE $160 APPLICATION capacity of a real (Idaho Real Estate Commission)

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Completed 28 December 2021

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