Fillable Exam/License Application Checklist (California Department of Real Estate)

Fill Online, Printable, Fillable, Blank Exam/License Application Checklist (California Department of Real Estate) Form

Use Fill to complete blank online CALIFORNIA DEPARTMENT OF REAL ESTATE pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Exam/License Application Checklist (California Department of Real Estate)

On average this form takes 24 minutes to complete

The Exam/License Application Checklist (California Department of Real Estate) form is 19 pages long and contains:

  • 0 signatures
  • 65 check-boxes
  • 64 other fields

Country of origin: US
File type: PDF

Use our library of forms to quickly fill and sign your California Department of Real Estate forms online.

BROWSE CALIFORNIA DEPARTMENT OF REAL ESTATE FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
This checklist may be used for either the salesperson or broker
exam/license applications.
Read appropriate license instructions carefully (RE 435A
or RE 436A).
Application must list your legal name.
Items to be included in your packet are listed below. Check

Mail completed application package and fee to:
Department of Real Estate
P.O. Box 137001
Sacramento, CA 95813-7001
BROKER APPLICANTS
Required documents …
RE 436 — Completed and signed by applicant.
Documentation to establish examination course
requirements have been met. Refer to RE 423 for current
requirements.


Documentation showing experience requirements
have been met. Please note that depending on your
circumstances, one or more of the forms listed below may
be required.
RE 226 — Documenting licensed experience.
RE 227 — Documenting non-licensed experience.
RE 228 — Two RE 228's are required if unable to
obtain broker's signature on RE 226 form.
RE 237 (See below.) — Completed by applicant and
live scan service operator.
License fee — Refer to RE 206 for current fees. Do not
send cash.
Cashiers’ check, check, or money order made payable
to: Department of Real Estate.
RE 909 — If paying by credit card.
SALESPERSON APPLICANTS
Required documents…
RE 435 — Completed and signed by applicant.
     
for Real Estate Principles, Real Estate Practice and/or
one other required course — not needed, if previously
submitted.
RE 237 (See below.) — Completed by applicant and
live scan service operator.
License fee — Refer to RE 206 for current fees. Do not
send cash.
Cashiers’ check, check, or money order made payable
to: Department of Real Estate.
RE 909 — If paying by credit card.
Titles of forms referenced by number. All of these forms
www.dre.ca.gov.
RE 206 Exam & Licensing Fees
 
 
 
RE 237 Live Scan Service Request (Applicant)
RE 237B Fingerprint Information
 
RE 435 Salesperson Exam/License Application
RE 435A Salesperson Exam/License Instructions
RE 436 Broker Exam/License Application
RE 436A Broker Exam/License Instructions
RE 243 License Application Demographic Survey
(Voluntary)
RE 909 Credit Card Payment
GENERAL INFORMATION

the original. You should return the second copy to DRE and keep the third copy for your records.


Exam/License Application Checklist
RE 216B (Rev. 11/20)
GENERAL INFORMATION
Apply for the real estate broker examination and the real estate broker license at the
same time.
Do not submit photocopies of this form or fax this form.
Read enclosed instructions (RE 436A) before completing and submitting this application
to ensure that you understand the requirements and that the proper qualifying documentation
and exam/license fee are submitted. Note: Fees submitted with this application are not
refundable or transferable. If you fail to qualify for or pass the examination within two

EFFECTIVE DATE EXPIRATION DATE
DATE EXAM PASSED
APPLICATION IS FOR (Must check one box):
C Real estate broker examination AND license – Complete Items 1-32.
L Real estate broker license ONLY (If already scheduled for examination)
– Complete Items 1-13 and 18-32.
FEES
REQUIRED
Exam............................$ 95
License.........................$300
Total due to DRE
with this application.....$395
APPLICANT INFORMATION
1. SOCIAL SECURITY NUMBER OR INDIVIDUAL TAXPAYER ID NUMBER (REQUIRED – REFER TO PRIVACY NOTICE ON RE 436A) 2. BIRTH DATE (MM/DD/YYYY)
3.
Have you ever applied for a California real estate exam?....................................................................................
If YES, list examination ID#. (If known.)..................................................................................................................
NO YES
____________________________________
4. APPLICANT’S NAME (MUST BE YOUR LEGAL NAME) - LAST FIRST MIDDLE SUFFIX
5A. MAILING ADDRESS – STREET ADDRESS OR POST OFFICE BOX
5B. CITY 5C. STATE 5D. ZIP CODE
6
. Do you reside in California?..................................................................................................................................
If NO, an “RE 234” is required (Refer to RE 436A).
YES NO
7. CURRENT PHONE NUMBER (required)
( )
8. CURRENT EMAIL ADDRESS (required - PRINT CLEARLY)
9. BUSINESS CELL PHONE NUMBER
( )
10. BUSINESS TELEPHONE NUMBER
( )
11. ARE YOU CURRENTLY SERVING IN THE U.S. MILITARY?
YES NO
12A. HAVE YOU PREVIOUSLY SERVED IN THE U.S. MILITARY? 12B. IF YES, WERE YOU HONORABLY DISCHARGED?
YES NO YES NO (see RE 436A for expedited processing instructions)
13. Do you now hold or have you ever held a California real estate license?............................................................
If YES, complete 13A, B, C, and D below.
YES NO
13A. TYPE OF LICENSE 13B. IDENTIFICATION NUMBER 13C. EXPIRATION DATE 13D. NAME ON LICENSE
EXAMINATION INFORMATION
14. When you are qualied for the examination would you prefer to use
eLicensing to schedule your own examination date?
YES – Please notify me by email when I am qualied for the examination.
NO – Proceed to item 15.
15. EXAM AREA PREFERENCE
SACRAMENTO FRESNO LOS ANGELES VICINITY OAKLAND SAN DIEGO OTHER:_____________________
16. EARLIEST DATE YOU CAN TAKE EXAM 17. REQUEST FOR REASONABLE ACCOMMODATION
(mm) (dd) (yyyy)
I am requesting reasonable accommodation; RE 413 & supporting documents are attached.



RE 436 (Rev. 11/20)
DRE RECEIVED DATE
DRE USE ONLY
LIC. ID
EXAM ID
DRE USE ONLY
RESTRICTED VIOLATIONS
FORM LETTER / NOTES EXAM PROCESSOR DATE PROCESSED
SENDER/DATE SENT LICENSE PROCESSOR DATE PROCESSED
DRE USE ONLY
DRE USE ONLY
RE 436 — Page 2 of 3
BACKGROUND INFORMATION
Carefully read and provide detailed answers to questions 25-28. You must provide a "yes" or "no" response to all questions, and completely and accurately
provide the detailed information required. Attach additional sheets if you need more space. Each additional sheet must be signed by the applicant. Failure
to disclose pertinent information may result in denial of your license application and/or delays.
25. HAVE YOU EVER HAD A DENIED, SUSPENDED, RESTRICTED OR REVOKED BUSINESS
OR PROFESSIONAL LICENSE (INCLUDING REAL ESTATE), IN CALIFORNIA OR ANY OTHER
STATE? IF YES, COMPLETE ITEM 29.....................................................................................................
YES NO
26. ARE THERE ANY LICENSE DISCIPLINARY ACTIONS PENDING AGAINST A BUSINESS OR
PROFESSIONAL LICENSE YOU HOLD AT THIS TIME? IF YES, COMPLETE ITEM 29.........................
YES NO
27. HAVE YOU EVER BEEN REQUIRED TO REGISTER AS A SEX OFFENDER PURSUANT TO THE
PROVISIONS OF SECTION 290 OF THE CALIFORNIA PENAL CODE OR ANY COMPARABLE LAW
OF ANY STATE OR GOVERNMENTAL UNIT? IF YES, COMPLETE ITEM 30.........................................
YES NO
28. HAVE YOU EVER BEEN ORDERED TO CEASE, DESIST AND/OR REFRAIN FROM DOING AN
ACT(S), OR FROM VIOLATING A LAW, RULE OR REGULATION BY, OR CITED FOR A BREACH
OF ETHICS OR UNPROFESSIONAL CONDUCT, BY AN ADMINISTRATIVE AGENCY OR
PROFESSIONAL ASSOCIATION IN CALIFORNIA OR ANY OTHER STATE?
IF YES, COMPLETE ITEMS 29-30................................................................................................................. YES NO
29. DETAILED EXPLANATION OF ITEM 25, 26 AND/OR 28. IF NEEDED, EXPLANATION MAY BE PROVIDED BELOW ON ITEM 30.
29A. TYPE OF LICENSE 29B. LICENSE ID NO. 29C. LICENSE EXPIRATION DATE 29D. STATE
29E. ACTION (revoked, etc.) 29F. DATE OF ACTION 29G. DATE ACTION TERMINATED 29H. CODE SECTION VIOLATED
NAME OF APPLICANT
LICENSE INFORMATION
18. HAVE YOU USED ANY OTHER NAMES (I.E., MAIDEN NAME, FORMER MARRIED NAMES, AKA’S, ETC.)?
YES — IF YES, LIST ALL NAMES USED: __________________________________________________________________________ NO
19. INITIAL WORKING STATUS (Must check one)
YES. PLEASE ISSUE MY LICENSE IN A WORKING STATUS WITH THE MAIN OFFICE
ADDRESS AS INDICATED ON ITEMS 20-23. WHEN MARKED "YES", ITEMS 20-23 MUST
BE COMPLETED.
NO. I DO NOT HAVE A MAIN OFFICE ADDRESS AT THIS TIME. PLEASE ISSUE MY
LICENSE IN A NON-WORKING STATUS. DO NOT COMPLETE ITEMS 20-23. LEAVE
ITEMS 20-23 BLANK.
20. MAIN OFFICE ADDRESS - STREET ADDRESS (MUST BE PHYSICAL ADDRESS)
21. CITY 22. STATE
CA
23. ZIP CODE
24. FICTITIOUS BUSINESS NAME(S) (DBA) — IF USING A FICTITIOUS BUSINESS NAME(S) INCLUDE A FILED COPY OF THE FICTITIOUS BUSINESS NAME STATEMENT(S) OB-
TAINED FROM THE COUNTY CLERK FOR EACH NAME. REFER TO RE 436A FOR ADDITIONAL INFORMATION.
I WILL USE A DBA DBA I WILL BE USING: ____________________________________________________________________________________________________
ADDITIONAL DBA OTHER DBA I WILL BE USING: ____________________________________________________________________________________________________
ADDITIONAL DBA OTHER DBA I WILL BE USING: ____________________________________________________________________________________________________
30. ADDITIONAL INFORMATION: SPECIFY WHICH LINES YOU ARE REFERRING TO. ATTACH EXTRA SHEETS IF MORE ROOM IS NEEDED. EACH
ADDITIONAL SHEET MUST BE SIGNED BY APPLICANT.
RE 436 — Page 3 of 3
NAME OF APPLICANT
BROKER EXAM & LICENSE CERTIFICATION
Exam — I hereby certify under penalty of perjury that I am aware of and meet all examination requirements as set forth in Section





not violate any provisions of the Real Estate Law nor abuse the privileges of a real estate license. I understand that the Department of

application.



or have the right to renewal of such real estate license or which relates to a transaction which occurred when I held such a real estate



workers’ compensation.



also understand that the Department may delay my renewal and toll the expiration date of my license pursuant to B&P Section 10177.
31. SIGNATURE OF APPLICANT (MUST BE ORIGINAL SIGNATURE)
@
32. DATE
GENERAL INFORMATION
This combination application may be used for the following
purpose:
• Applying for the real estate broker examination and the
real estate broker license at the same time.
The application must be mailed. You cannot apply using
eLicensing. DRE will not accept a faxed RE 436. The RE 436
application must have the original signatures.
The following fees must be included with your application (fees
are subject to change):
• The current examination fee is $95 and the current license
fee is $300. Total due to DRE with this application: $395.
• Note: Once the Department receives your application,
the fees for the examination and license are not
refundable or transferable to another application
pursuant to B&P Code section 10207.
• Fee valid for two years — A new application, fee, and

for and pass the examination during that two year period.
The following must be submitted before your exam can be
scheduled and your license can be issued:
• Proof of completion of the required education and
experience. Refer to Instructions to License Applicants
handbook for further information.
• A copy of the completed Live Scan Service Request (RE
237) (refer to Fingerprint Information).
Please read all examination and license information/instructions
before completing and submitting this application; type or print
in ink.
GENERAL APPLICANT INFORMATION
•
You can only be scheduled for one broker examination date
at a time.
•
Name — To avoid delays in the processing of your exam/
license application(s) you must provide your legal name.
Further, the name listed as your legal name must appear
on all accompanying documents, including Completion
      
       
change or discrepancy between your legal name and the
name you used in applying for the examination or the name

•
Mailing address — Use of a real estate school/business mailing
address (item #5A-D) may cause a delay in mail delivery. If you
are not a resident of California, submit a notarized Consent to
Service (RE 234) form. You may change your mailing address
online using eLicensing at www.dre.ca.gov or by submitting
a Broker Examination Change Application (RE 415B).
•
Business, examinee, and licensee mailing addresses are public
information and as such are posted on the Internet and are
available from DRE via download, telephone, or written requests.
Please consider this when identifying a business, examinee, or
licensee mailing address.
•
The examination is qualifying in nature, therefore if you
pass, an actual score will not be released.
EXAMINATION SCHEDULING INFORMATION
• Schedules and examination locations are subject to change.
 
can schedule yourself on eLicensing.
• Broker examinations are usually given: Weekdays as needed
in Fresno, the Los Angeles vicinity, Oakland, Sacramento, and
San Diego. At www.dre.ca.gov you can view a calendar of
examination dates and locations currently being scheduled. Since
DRE allows reschedule requests online, by phone and through

may not be available; therefore, requests cannot be guaranteed.
 
examination or DRE will schedule you. If you indicate on the
application (item #14) that you want to schedule yourself for
the examination, an email will be sent to you advising you that
eLicensing to schedule
your examination.
•
If you do not provide a date in item #16, and do not request
self-scheduling (item #14), you will be scheduled for the
earliest available date in the area chosen.
• Exam date notication — Processing timeframes are listed
at www.dre.ca.gov. These timeframes estimate when the
processing of your application should be completed.
 
within the timeframes listed on our Web site, you can obtain
your scheduled date through eLicensing at www.dre.ca.gov.
• If you have not yet been assigned an exam date or received a

the processing timeframes, check with your bank or credit card
company to assure that DRE has processed your fee.
• Applicants with limitations requiring reasonable accommodations
must submit a Reasonable Accommodation Request for
Examination (RE 413) as well as the required documentation
as noted on the RE 413, with this exam application. Do not
attempt to schedule a reasonable accommodation via our
Web site, as eLicensing does not provide such a service
.
Compliance with reasonable accommodation requests may
be limited by scheduling constraints.
• Use eLicensing for expedited processing to reschedule an
examination, review your examination results and records,
request a duplicate schedule or result notice, and change your
examination mailing address.
All exam scheduling transactions done by the examinee in
eLicensing



RE 436A (Rev. 11/20)
RE 436A — Page 2 of 4
EDUCATION REQUIREMENTS
Successful completion of the following eight college-level courses
is required: Legal Aspects of Real Estate, Real Estate Appraisal,
Real Estate Economics or General Accounting*, Real Estate
Finance, Real Estate Practice; and three courses from the following
electives: Advanced Legal Aspects of Real Estate, Advanced Real
Estate Appraisal, Advanced Real Estate Finance, Business Law,
Common Interest Developments, Computer Applications in Real
Estate, Escrows, Mortgage Loan Brokering and Lending, Property
      
Principles.
*If both Real Estate Economics and General Accounting are
completed, only two courses from the electives are required.
Each college- level course must be at least three semester units or
four quarter units. Courses must be completed at an institution of
higher learning accredited by the Western Association of Schools and
Colleges or by a comparable regional accrediting agency recognized
by the U.S. Department of Education, or by a private real estate
school, which has courses approved by the California Real Estate
Commissioner. Courses completed through foreign institutions of
higher learning must be evaluated by a foreign credentials evaluation
service approved by DRE. See Examination Applicant Foreign
Education Information (RE 223).

completed courses. Courses submitted as equivalent to the required
         
description in order to be evaluated for equivalency.
EXPERIENCE REQUIREMENTS
A minimum of two years full-time licensed salesperson experience

is required. The following are acceptable methods of documenting
the experience requirement for the broker examination.
Verication of licensed sales experience
Holding a salesperson license for two years does not necessarily
qualify an applicant for a broker license. The applicant must document
experience as a licensed salesperson on a full-time basis (or part-time





examination application.
Verication of non-licensed experience
A claim of non-licensed experience, in lieu of the two years of sales
experience, may be based on any combination of licensed experience
and non-licensed experience, which, considered as a whole, would
satisfy the intent of the law.
An applicant who has not been active as a licensed real estate
salesperson may be eligible for the broker examination, provided

acceptable real estate-related experience is submitted. The RE 227
form(s) must be completed in full and must have two verifying
signatures on each form.
When submitting the RE 227 form(s), it is important that an applicant

to perform an evaluation. DRE may conduct further inquiry when
evaluating non-licensed experience, including requesting additional

Regardless of the experience, the eight college-level courses required
for a broker's license must be completed and cannot be waived based
on non-licensed experience.
Acceptable Kinds of Non-Licensed Experience
An applicant may qualify with two years full-time experience, in
any of the following areas:
 

property.
2. Experience as a subdivider, or speculative builder, during which
time the applicant performed comprehensive duties relating to

property. General contracting experience does not satisfy the
intentof the law.
3. Experience as a real property appraiser.
4. Experience as a licensed real estate professional in another state
or country.
The above-referenced patterns are designed to assist the applicant in
understanding the general types of non-licensed experience which
can be used to qualify for the broker examination. Other types of
real estate-related experience will be considered, provided that it

for equivalency by unlicensed persons for activities which require
a real estate license will not be considered.
Active military and veteran applicants can apply their military
experience and training, as it relates to real estate-related activities

requirements.
: 

corporation information, tax forms and proof of real property
ownership will facilitate the review of an application. Do not

submissions. Be accurate as to experience and transaction dates,
etc., as incompleteness or inaccuracies will result in delays and
additional correspondence. All attachments must be signed by the

Education in Lieu of Experience
An applicant with a degree from an accredited four-year college
or university which included a major or minor in real estate may
be exempt from the two-year salesperson experience requirement.


institutions do not qualify. Degrees earned through foreign institutions
of higher learning must be evaluated by a foreign credentials
evaluation service approved by DRE. See Examination Applicant
Foreign Education Information (RE 223) for further information.
Evaluation of experience

be scheduled for the broker examination. Evaluations of claimed
experience or education cannot be conducted with applicants in
RE 436A — Page 3 of 4
           
wants an evaluation of college courses, degree or experience they
must submit a completed application and fee.
MEMBERS OF THE CALIFORNIA STATE BAR
Members of the California State Bar are statutorily exempt from
the college-level course requirements. Evidence of admission to
practice Law in California must be furnished, such as a photocopy
of both sides of a California State Bar membership card. However,
members of the California State Bar would still need to demonstrate

experience requirement or have at least two years real estate related
experience while practicing law in California. Members of the State
Bar of California using non-licensed experience should submit a
RE 227 form outlying this non-licensed experience along with their
application.
CURRENTLY OR PREVIOUSLY LICENSED?

in California, or if your license expired less than two years ago,
you are not eligible to take an examination for that type of license
Note:
than two years will protect your right to obtain an individual broker
license.
GENERAL LICENSE INFORMATION
• 
fee, education or experience requirements, or completed Live
Scan Service Request (RE 237) will delay the processing.
• You may check to verify that your license has been issued by
referencing the license status look up at www.dre.ca.gov. Current
processing timeframes for properly completed applications are
posted on the Web site.
• Forms referenced in these instructions can be obtained from
the DRE Web site.
• Once you pass the exam and are issued the license, you may
use eLicensing

If Item #19 Is Yes, Then Complete Items #20-23
Main oce address — Enter your primary business location (a
California address) at the time your license will be issued. If a
street address is unavailable, indicate the physical location; use the

alone is not acceptable. If you are not a California resident and you
do not maintain a California business address, leave items 20-23
blank and also submit an Out-of-State Broker Acknowledgment
        
and as such is posted on the Internet and available from DRE via
telephone and written request.
Using a ctitious business name/doing business as (DBA) — Enter
the name exactly as it appears on the Fictitious Business Name



 
the county, you may wish to contact a local DRE district

already in use by another broker.
• Proof of Publication is not acceptable. *Unless it bears the
County Clerk's "Filed" stamp.
• Do not
working as a broker-associate.
• Legible photocopies of the FBNS are acceptable.
• An individual broker may not be issued a license with a DBA
which implies the existence of a corporation, is otherwise
misleading, or which would constitute false advertising.

Background Information
•  background information questions (items 25-28) must be
answered and a full explanation must be provided if any of the

will delay the processing of your license.
• 
and #32.
FINGERPRINT INFORMATION
Completion & Submission of RE 237
        
every real estate license applicant. Fingerprints must be submitted
through the California Department of Justice (DOJ) Live Scan
Program. A Live Scan Service Request (RE 237) may be obtained
online at www.dre.ca.gov.
          
provider, either submit a completed copy of RE 237 with this
        
later date, submit a completed copy of RE 237 to the Department
of Real Estate, P.O. Box 137002, Sacramento, CA 95813, Attn:
Fingerprint Desk. Your license will not be issued until a report from
the Department of Justice is received stating that there is no criminal
history, or disclosing the existence of criminal history information.
If prior criminal information is disclosed in the report, further
background inquiry may be required before your license is issued.
Fingerprint services (Contact the facility for fees/hours)
Many California law enforcement agencies and other private

www.dre.
ca.gov or by visiting the Department of Justice's Web site at www.
ag.ca.gov. Please note that the hours of operation for each provider
may vary and an appointment may be required.
Out-of-state applicants
Out of state residents either need to make arrangements to get their



Licensing Section at 877-373-4542. It should be taken to a local
law enforcement agency for completion and submitted directly to
DRE with the completed exam/license application, exam/license

NOTICE ABOUT THE SAFE ACT
All DRE licensees who conduct residential mortgage loan activities,
as outlined in the federal SAFE Act, must obtain a mortgage loan
RE 436A — Page 4 of 4
originator (MLO) license endorsement in order to perform these
types of activities (SB 36, Calderon, Chapter 160, Statutes of 2009).
MLO license endorsement applications must be submitted through
the Nationwide Multistate Licensing System & Registry (NMLS)
and applicants must successfully complete the National test with

through NMLS and pay required license endorsement fees, submit
        
requirement, and submit authorization for NMLS to obtain a credit
report. All MLO license endorsements expire on December 31
st
and

NMLS along with the appropriate fees, and evidence of completion

regarding obtaining a MLO license endorsement can be found on
our Web site.
RE 866 Filing Requirements
All DRE licensees must report to the Department of Real Estate if
they make, arrange, or service loans secured by residential property,
1 to 4 units, under the authority of the Real Estate Law. The report
must be made within 30 days of commencing such activity and
must be completed online using Form RE 866 – Mortgage Loan


SUBVERSION OF EXAMINATION
It is a misdemeanor for any person to subvert or attempt to subvert
any licensing examination. Sections 123, 123.5, 496, 10153.01 and
10153.1 of the Business and Professions (B&P) Code relate to test
security and provide that DRE may deny, suspend, restrict or revoke
the license of an applicant or licensee who subverts or attempts to
subvert a licensing examination.
In addition to any other penalties, a person found guilty of violating
Section 123 of the B&P Code shall be liable for the actual damages
sustained by the agency administering the examination not to exceed
ten thousand dollars ($10,000) and the costs of litigation.
FEES, PAYMENT & MAILING INFORMATION
Fees are subject to change.
Fees – Broker
Exam ....................................$ 95
License .................................$300
Total due to DRE
with this application ...........$395
Fingerprint Fee .....................$ 49
Fingerprint fee — Applicants who reside in California will

reside out of state
        

Missing requirements may be submitted anytime within the two year
period after DRE receipt of your application/fee. A new application,

and pass the examination during that two year period.
The fees for the examination and license are not refundable
or transferable to another application pursuant to B&P Code
section 10207.
Acceptable payment methods     
check or credit card.
• Make check or money order payable to: Department of Real

• If paying by credit card, use a Credit Card Payment
(RE 909).
Mail To — Department of Real Estate
P.O. Box 137001
Sacramento, CA 95813-7001
DRE Licensing can be contacted toll free at 877-373-4542.
EXPEDITED PROCESSING FOR U.S. VETERANS
Honorably discharged veterans of the U.S. Armed Forces are eligible
for expedited processing.
• In order to obtain expedited processing, please submit
a copy of your U.S. DD Form 214, NGB-22 form, or


documents, and fee.
• Please note that applications received to this P.O. Box from
non-honorably discharged veterans will be processed in date
received order.
Mail To — Department of Real Estate
P.O. Box 137014
Sacramento, CA 95813-7014
Attn: Expedited Military Processing

Section 1798.17 of the Civil Code requires this notice be provided when
       
individual has the right to review personal information maintained by this
Agency, unless access is exempted by law.
Department of Real Estate Assistant Commissioner
1651 Exposition Blvd. Licensing & Administration
Sacramento, CA 95815 Telephone: 877-373-4542
General powers of the Commissioner, Sections 10050, 10071, and 10075
of the Business and Professions Code authorizes the maintenance of this
information.
Business and Professions Code Sections 30, 31(e) and 494.5(d) require
each real estate licensee to initially provide to the Department of Real
Estate his or her social security number which will be furnished to the
Franchise Tax Board. The Franchise Tax Board will use your number
         
sections also require that each application for a new license or renewal

and the Franchise Tax Board will share taxpayer information with the
Department of Real Estate, and that failure to pay tax obligations may
result in a suspension or denial of a license. The Board of Equalization
and Franchise Tax Board require the Department to collect social
        
purposes of matching the names of the 500 largest tax delinquencies
pursuant to Section 7063 or 19195 of the Revenue and Taxation Code.

shall not be deemed public records and shall not be open to the public
for inspection.
The Real Estate Law and the Regulations of the Commissioner require
      
or any part of the required information is not provided, processing may
be delayed. In addition, the Commissioner may suspend or revoke a
license, or in the case of a license applicant, may deny the issuance for
misstatements of facts (including a failure to disclose a material fact) in
an application for a license.
The information requested in this form is primarily used to furnish

to answer inquiries and give information to the public on license status,
mailing and business addresses and actions taken to deny, revoke, restrict
or suspend licenses for cause.
This information may be transferred to real estate licensing agencies
        
Departments, District Attorneys, Attorney General, F.B.I.), and any
other regulatory agencies (i.e., Department of Business Oversight,
      
Bar Association).
APPLICANT NAME (LAST, FIRST, & MIDDLE INITIAL)
FORMER NAME/AKA’S (LAST, FIRST)
DATE OF BIRTH (MM/DD/YYYY) GENDER HEIGHT WEIGHT
MALE FEMALE
EYE COLOR HAIR COLOR PLACE OF BIRTH
SOCIAL SECURITY NUMBER CALIFORNIA DRIVER’S LICENSE NO. AGENCY BILLING NUMBER
RESIDENCE ADDRESS (STREET/P.O. BOX, CITY, STATE, ZIP CODE)
YOUR OCA NUMBER (USE SOCIAL SECURITY NUMBER) LEVEL OF SERVICE
CALIFORNIA DEPARTMENT OF JUSTICE / FBI


 (Applicant/Petitioner)
7
PART 3 LIVE SCAN TRANSACTION
AGENCY ADDRESS SET
CALIFORNIA DEPARTMENT OF REAL ESTATE
1651 EXPOSITION BLVD, SACRAMENTO CA 95815
APPLICATION TYPE
LICENSE, CERTIFICATION, OR PERMIT
APPLICATION TITLE
REAL ESTATE LICENSE
OPERATOR NAME DATE COMPLETED TRANSMITTING AGENCY
AMOUNT COLLECTED (FOR ROLLING FEE) AMOUNT COLLECTED (FOR DOJ/FBI PROCESSING) ATI NUMBER
PART 1 CONTRIBUTING AGENCY
PART 2 APPLICANT’S PERSONAL INFORMATION
Original Copy Second Copy Third Copy
Live Scan Operator Department of Real Estate Applicant
Attention - Live Scan Service Providers



should be 

E-MAIL CODE
09416
CONTACT NAME
LICENSING SECTION
CONTACT TELEPHONE NUMBER
1-877-373-4542
Instructions on reverse.
Fees paid by applicant
ORIGINAL ATI NUMBER LEVEL OF SERVICE REQUESTED FOR RESUBMISSION
CALIFORNIA DEPARTMENT OF JUSTICE FBI
PART 4 LIVE SCAN RESUBMISSION TRANSACTION
AGENCY ORI NUMBER
A0075
I have received and read the included Privacy Notice, Privacy Act Statement, and Applicant's Privacy Rights.
Applicant Signature Date
RE 237 Page 2 of 4
APPLICANT INSTRUCTIONS
Fingerprint Requirement




         




        




         







          



Completion of Form RE 237 Live Scan Service
Request


 
 



 




Submission of Fingerprint Form





         

Fees
Processing fee      
        

Service fee



Fingerprint Services (Contact the facility for fees &
hours.)
      
     


   


RE 237 Page 3 of 4


                  
                 
                
            
             
               
                      
                     
                      
                 







































RE 237 Page 4 of 4













































GENERAL INFORMATION
The Department of Real Estate is required to collect demographic information regarding applicants for licensure pursuant to Business
& Professions Code 480 et seq., if the applicant chooses to provide this information. Providing this information is voluntary, and
providing responses will not impact the Department’s review of your license application.
GENDER:
ETHNIC IDENTITY:
ASIAN PACIFIC ISLANDER
BLACK OR AFRICAN AMERICAN
AMERICAN INDIAN OR ALASKA NATIVE
HISPANIC OR LATINO (ALONE OR IN
COMBINATION WITH ANY OTHER RACE)
WHITE
MULTIPLE RACES*
I CHOOSE NOT TO IDENTIFY
MULTIPLE ASIAN**
INDIAN
CAMBODIAN
CHINESE
FILIPINO
JAPANESE
KOREAN
LAOTIAN
VIETNAMESE
OTHER ASIAN
MULTIPLE PACIFIC ISLANDER***
GUAMANIAN
HAWAIIAN
SAMOAN
OTHER PACIFIC ISLANDER
* If you identify with more than one race that is Non-Hispanic or Latino, select Multiple Races.
** If you identify with more than one Asian ethnicity, select Multiple Asian
*** If you identify with more than one Pacic Islander ethnicity, select Multiple Pacic Islander
State of California
Department of Real Estate
License Application Demographic Survey
RE 243 (Rev. 7/20)
Male Female Non-binary
Thank You For Completing This Questionnaire
I choose not to identify
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

ExamLicense Application Checklist (California Department of Real Estate)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 13 July 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document