Fillable Form 3102: Membership Camping Resort Sa les Person (Texas Secretary of State)

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Form 3102: Membership Camping Resort Sa les Person (Texas Secretary of State)

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The Form 3102: Membership Camping Resort Sa les Person (Texas Secretary of State) form is 2 pages long and contains:

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Membership Camping Resort
Sa
les Person or Contract-Broker
Registration Application
Form 3102
(Revised 03/15)
Submit to:
Secretary of State
Registrations Unit
P.O. Box 13550
Austin, TX 78711-3550
512 475-0775
FAX: 512 475-2815
Filing Fee: $50.00
I am applying for: (please circle one) SALESPERSON CONTRACT-BROKER
1. Name of Applicant:
2. Residence Address:
3. Telephone Numbers: Home ( ) Business ( )
4. Business Address:
5. Name of Employer: (if applicable)
6. Address of Employer:(if applicable)
7. Have you ever been convicted of a felony or a misdemeanor involving moral turpitude?
_________ Yes _________No
8. If you answered yes to Question 7, describe the nature of the crime, when and where it was committed, and
the disposition of the conviction.
9. Have you been refused a real estate broker's or salesperson's license, or any other occupation license in this or any other state?
________Yes ________ No
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
_____________________________________________________________________________________
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10. If you answered yes to Question 9, explain fully the circumstances of the refusal.
11. Has your license as a real estate broker or salesperson in this or any other state ever been revoked or
suspended?
_______ Yes ________ No
12. If you answered yes to Question 11, explain fully the circumstances of the denial or suspension.
I certify (or declare), under penalty of perjury, that I have read the foregoing registration and that all the answers are
true and correct. Further, I understand and agree that any misstatements of a material fact in this application may
result in suspension or revocation of my registration with the State of Texas.
Signature of Applicant
RETURN THIS APPLICATION WITH THE $50.00 FILING FEE TO:
SECRETARY OF STATE
REGISTRATIONS UNIT
P. O. BOX 13550
AUSTIN, TX 78711-3550
FOR DELIVERY:
JAMES EARL RUDDER OFFICE BUILDING
1019 BRAZOS
AUSTIN, TX 78701
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Form 3102: Membership Camping Resort Sa les Person (Texas Secretary of State)

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Completed 6 November 2020

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