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Commonwealth of Massachusetts REGISTERING AN APPRAISAL MANAGEMENT COMPANY (Commonwealth of Massachusetts)

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Commonwealth of Massachusetts
Division of Professional Licensure
BOARD OF REGISTRATION OF REAL ESTATE APPRAISERS
1000 Washington Street Boston Massachusetts 02118
REGISTERING AN APPRAISAL MANAGEMENT COMPANY
HOW TO APPLY
Email the required form and supporting documentation to the Board at dpl-appraiser-
board@mass.gov. The form must be typed.
REQUIRED DOCUMENTS
Please review the list below for a summary of the documents required for the Appraisal
Management Company application:
• Application;
• A notarized Criminal Offender Record Information (CORI) Authorization Form
completed and signed by the applicant. A completed CORI Form must be submitted
with the Application for every person who owns more than 10% of the company OR is
an officer of the company OR has been designated as the company’s controlling person,
employee in charge, or managing principal of the entity; and
• Irrevocable Uniform Consent to Service of Process.
• NOTE: All companies that are registered with the Board will in the future be required
to file a Surety Bond in an amount to be determined by the Board and in the name of
the Appraisal Management Company.
APPLICATION REVIEW AND PROCESSING TIME
Please note that it takes a minimum of two (2) business days for the Board to review and
approve an application. The Board will review complete applications only. Failure to submit
all required information or supporting documents will result in your application being
deemed incomplete or denied.
APPLICATION APPROVAL AND LICENSE ISSUANCE
Once approved, the Board will mail an approval letter to the mailing address provided by the
applicant during the application process.
QUESTIONS
Question regarding the real estate appraisal management company application process
should be directed to the Board office calling 617-727-3055 or emailing dpl-appraiser-
board@mass.gov.
Commonwealth of Massachusetts
Division of Professional Licensure
BOARD OF REGISTRATION OF REAL ESTATE APPRAISERS
1000 Washington Street Boston Massachusetts 02118
Page 2 of 10
APPRAISAL MANAGEMENT COMPANY
REGISTRATION APPLICATION
Date Received:
Issue Date:
Expiration Date: _________________
Registration Number: _________________
Please Complete all Fields
Legal Company Name
Trade Name/ DBA (if applicable)
Physical Address
City
State
Zip Code
Mailing Address
City
State
Zip Code
Phone Number
Email Address
FEIN Number
Commonwealth of Massachusetts
Division of Professional Licensure
BOARD OF REGISTRATION OF REAL ESTATE APPRAISERS
1000 Washington Street Boston Massachusetts 02118
Page 3 of 10
Registered Agent Name
Address
City
State
Zip Code
Phone Number
Email Address
Contact/Controlling Person Name
Address
City
State
Zip Code
Phone Number
Email Address
Appraiser License Number (Optional)
Issuing State
Employee in Charge Name
Address
City
State
Zip Code
Phone Number
Email Address
Appraiser License Number MANDATORY
Issuing State
Commonwealth of Massachusetts
Division of Professional Licensure
BOARD OF REGISTRATION OF REAL ESTATE APPRAISERS
1000 Washington Street Boston Massachusetts 02118
Page 4 of 10
1. I certify that the entity requires appraisers completing appraisals at its request to comply with the
Uniform Standards of Professional Appraisal Practice, including the requirements for geographic
and product competence, and I certify that the applicant has a system in place to review the work
of all real estate appraisers who perform real estate appraisal services for the applicant on a periodic
basis to confirm that those services are being performed in accordance with the Uniform Standards
of Professional Appraisal Practice Yes No
2. I certify that the company is not owned in whole or in part by any person, directly or indirectly,
who has had an appraiser license or certificate in this state or in any other state, refused, denied,
cancelled, surrendered in lieu of revocation, or revoked, unless such license or certificate was
subsequently granted or was not revoked for substantive cause and was subsequently reinstated.
Yes No
3. I certify that no person who owns more than 10 percent of the company and no person who has
been designated as the company’s controlling person or employee in charge has been convicted of,
or entered a plea of nolo contendere to, a felony or, within the last five (5) years, convicted of a
misdemeanor involving an activity related to the transfer of real property including, but not limited
to, real estate appraisal, mortgage lending or any offense involving breach of trust, moral turpitude
or fraudulent or dishonest dealing. Yes No
4. I certify that the entity will maintain a detailed record of each service request that it receives and
the appraiser who performs the residential real estate appraisal services for the appraisal
management company, and a complete digital copy of every version of each appraisal report
completed by the appraiser. Yes No
5. I certify that the entity has a system and process in place to verify that an individual being added to
the appraiser panel of the Appraisal Management Company holds a license in good standing.
Yes No
6. I certify that the entity has a system and process in place to verify that only licensed or certified
appraisers are used for federally related transactions. Yes No
7. I certify that the entity has a system and process in place to verify that a person being added to the
appraiser panel of the appraisal management company for appraisal assignments on real property
located in the commonwealth holds a Massachusetts appraiser license or certification in good
standing issued by the board. Yes No
8. I certify that the entity has a system or process in place to ensure that the entity, in engaging an
appraiser, selects an appraiser who is independent of the transaction and who has the requisite
education, expertise, and experience necessary to competently complete the appraisal assignment
for the particular market and property type. Yes No
9. I certify that the entity has a system or process to require that appraisals are conducted
independently and free from inappropriate influence and coercion as required by the appraisal
independence standards established under section 129E of the Truth in Lending Act, 15 U.S.C.
§ 1639e(a)-(i), including the requirement that fee appraisers be compensated at a customary and
Commonwealth of Massachusetts
Division of Professional Licensure
BOARD OF REGISTRATION OF REAL ESTATE APPRAISERS
1000 Washington Street Boston Massachusetts 02118
Page 5 of 10
reasonable rate when the appraisal management company is providing services for a consumer
credit transaction secured by the principal dwelling of a consumer. Yes No
10. Has the entity for which this application is submitted ever been convicted of a crime? If “yes” you
must provide a detailed written explanation and attach copies of relevant court documents.
Yes No
11. Does the entity for which this application is submitted have any criminal charges pending against
it in any jurisdiction (USA or elsewhere)? If “yes” you must provide a detailed written explanation
and attach copies of the charging documents. Yes No
Commonwealth of Massachusetts
Division of Professional Licensure
BOARD OF REGISTRATION OF REAL ESTATE APPRAISERS
1000 Washington Street Boston Massachusetts 02118
Page 6 of 10
LIST EVERY PERSON WHO DIRECTLY OR INDIRECTLY OWNS MORE THAN
10% OF THE ENTITY APPLYING FOR REGISTRATION OR IS AN OFFICER,
CONTROLLING PERSON, EMPLOYEE IN CHARGE OR MANAGING PRINCIPAL (Copy as
needed)
Name
License Number (if applicable)and
state of issuance
Address
City
State
Zip Code
Email Address
Phone Number
Name
License Number (if applicable) and
state of issuance
Address
City
State
Zip Code
Email Address
Phone Number
Name
License Number (if applicable) and
state of issuance
Address
City
State
Zip Code
Email Address
Phone Number
Name
License Number (if applicable) and
state of issuance
Address
City
State
Zip Code
Email Address
Phone Number
Commonwealth of Massachusetts
Division of Professional Licensure
BOARD OF REGISTRATION OF REAL ESTATE APPRAISERS
1000 Washington Street Boston Massachusetts 02118
Page 7 of 10
I, ____________________________________________, hereby state under the pains and
penalties of perjury that the information provided on this application for licensure or attached or
incorporated herein is truthful and accurate.
Company Name: ____________________________________________________
By:
________________________________________
Signature of Employee in Charge
_________________________________________
Type Name of Employee in Charge
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Commonwealth of Massachusetts
Division of Professional Licensure
BOARD OF REGISTRATION OF REAL ESTATE APPRAISERS
1000 Washington Street Boston Massachusetts 02118
Page 8 of 10
IRREVOCABLE UNIFORM CONSENT TO SERVICE OF PROCESS:
WHEREAS I have made application for an appraisal management company registration to practice in the
Commonwealth of Massachusetts in accordance with the provisions of General Laws Chapter 112,
§§ 276-289 and
WHEREAS, pursuant to General Laws Chapter 112, §§ 276-289 it is necessary for an appraisal
management company applicant to file an irrevocable consent to service agreement with the Executive
Director of the Board of Registration of Real Estate Appraisers within the Division of Professional
Licensure;
NOW, THEREFORE, I hereby execute and file with the Executive Director of the Board of Registration
of Real Estate Appraisers this irrevocable consent that actions may be commenced against the appraisal
management company in the proper court of any count in the Commonwealth of Massachusetts in which
a cause of action may arise or in which the Plaintiff may reside, by the service of any process or pleadings
authorized by the laws of the Commonwealth of Massachusetts on the Executive Director of the Board
of Registration of Real Estate Appraisers. Furthermore, it is hereby stipulated and agreed that service of
the process or pleading on the Executive Director of the Board shall be taken and held in all courts as
valid and binding as if due service had been made upon me personally within the Commonwealth of
Massachusetts.
IN WITNESS WHEREOF I have hereunto signed my name.
____________________________________________ ___________________
Signature of Controlling Person Date
___________________________________________
Name Printed
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signature
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Commonwealth of Massachusetts
Division of Professional Licensure
BOARD OF REGISTRATION OF REAL ESTATE APPRAISERS
1000 Washington Street Boston Massachusetts 02118
Page 9 of 10
CRIMINAL OFFENDER RECORD INFORMATION (CORI)
ACKNOWLEDGEMENT FORM
Submit one completed two-page form for every person who owns more than 10% of the company
OR who is an officer OR has been designated as the company’s controlling person, employee in
charge or managing principal of the entity
The Division of Professional Licensure by itself and on behalf of boards of registration pursuant to
M.G.L. c. 13, §9 [hereinafter, “Division of Professional Licensure”] is registered under the provisions of
M.G.L. c. 6, § 172 to receive CORI for the purpose of screening current and otherwise qualified
prospective license applicants and current licensees.
As a license applicant or current licensee who owns more than 10% of the company OR who is an
officer OR has been designated as the company’s controlling person, employee in charge or
managing principal of the entity, I understand that a CORI check will be submitted for my
personal information to the Department of Criminal Justice Information Services (“DCJIS”). I
hereby acknowledge and provide permission to the Division of Professional Licensure to submit a CORI
check for my information to the DCJIS. This authorization is valid for one year from the date of my
signature. I may withdraw this authorization at any time by providing the Division of Professional
Licensure written notice of my intent to withdraw consent to a CORI check.
FOR LICENSING PURPOSES ONLY:
I also understand that the Division of Professional Licensure may conduct subsequent CORI checks
within one year of the date this Form was signed by me.
By signing below, I provide my consent to a CORI check and acknowledge that the information provided
on Page 2 of this Acknowledgement Form is true and accurate.
_________________________________ _________________________________
Signature Date
NOTE: DPL cannot accept this two-page CORI acknowledgment form unless it is signed in the presence
of a notary public who has likewise verified identity.
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Commonwealth of Massachusetts
Division of Professional Licensure
BOARD OF REGISTRATION OF REAL ESTATE APPRAISERS
1000 Washington Street Boston Massachusetts 02118
Page 10 of 10
SUBJECT INFORMATION: (An asterisk (*) denotes a required field)
_____________________________________________________________________________________
*Last Name *First Name Middle Name Suffix
_____________________________________________________________________________________
*Maiden Name (or other name(s) by which you have been known)
___________________ ____________________________
*Date of Birth Place of Birth
*Last Six Digits of Your Social Security Number: ________ - ___________
Sex: ________ Height: ____ ft. ____ in. Eye Color: _________
Driver’s License or ID Number: ___________________ State of Issue: __________________
Current and Former Addresses:
_____________________________________________________________________________________
Street Number & Name City/Town State Zip
_____________________________________________________________________________________
Street Number & Name City/Town State Zip
______________________________________________________________________________
IDENTITY VERIFICATION SECTION:
VERIFICATION BY NOTARY:
On this ______ day of _____________, 20____, before me, the undersigned notary public, personally
appeared _________________________________ (name of document signer), and proved to me
through satisfactory evidence of identification, which was the following:
Passport State-issued driver’s license Military identification
State-issued identification card
to be the person whose name is signed on the preceding or attached document, and acknowledged to
me that (he) (she) signed it voluntarily for its stated purpose.
__________________________________________________________________________________
Notary Public: Notary Commission Expires On
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Commonwealth of Massachusetts REGISTERING AN APPRAISAL MANAGEMENT COMPANY (Commonwealth of Massachusetts)

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Completed 20 July 2020

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