Fillable DUPLICATE LICENSE REQUEST (Utah DRE)

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DUPLICATE LICENSE REQUEST (Utah DRE)

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The DUPLICATE LICENSE REQUEST (Utah DRE) form is 1 page long and contains:

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Country of origin: US
File type: PDF

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Utah Division of Real Estate (DRE) aims to protect the public and promote responsible business practices through education, licensure, and regulation of real estate, mortgage, and appraisal professionals

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Rev. 3/24/2015
160 East 300 South, PO Box 146711, Salt Lake City, UT 84114-6711
Telephone (801) 530-6747 • Facsimile (801) 526-4387 • Internet: www.realestate.utah.gov • Email: realestate@utah.gov
State of Utah
Department of Commerce
Division of Real Estate
DUPLICATE LICENSE REQUEST
Please complete, sign, and submit this form along with a $10 non-refundable fee to
the Utah Division of Real Estate by fax, mail, email, or in person at the address below.
** LICENSE WILL BE MAILED TO THE ADDRESS ON RECORD**
Name: ______________________________________________________________________________
License #: _____________________________________
Phone: __________________________________ Email: _________________________________
LICENSE TYPE*: ( ) Appraiser ( ) AMC ( ) Real Estate Agent ( ) Real Estate Broker
( ) Mortgage Loan Originator ( ) Mortgage Entity
*Note: Real Estate and Appraisal licensees can print their own license free of charge by logging into
their RELMS account.
( ) Check ( ) Visa ( ) MasterCard ( ) American Express
Make checks payable to: Utah Division of Real Estate
Card # _____________________________ Expires ______________
Signature__________________________ CCV# ________________
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DUPLICATE LICENSE REQUEST (Utah DRE)

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Completed 14 February 2021

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