229 Peachtree Street NE
Atlanta, GA 30303-1605
Phone: 404-656-3916
Fax: 404-656-6650
Suite 1000 - International Tower
GREAB Change App (11-2014)
Page 1 of 1
Georgia Real Estate Commission
Georgia Real Estate Appraisers Board
www.grec.state.ga.us
Email: grecmail@grec.state.ga.us
Zip Code:
State:
Alternate Phone Number:
County:
City:
Mailing Address:
This form can be filled out online. Print TWO copies: one to sign and submit for processing and one for your records. If a fee and/or
documentation is required, attach to the application and mail to the address above. Incomplete applications will be returned
unprocessed and result in a $25.00 charge. Contact information may also be changed online at www.grec.state.ga.us.
Section A
Appraiser Information
Appraiser Name:
Appraiser Change Application
Residence Address:
State:
Zip Code:
City:
County:
Phone Number:
Classification Number:
Email:
Zip Code:
State:
Phone Number:
County:
City:
Business Address:
Fax:
Change Request
Section B
LIC#
INV
Codes
Proc By &Proc Date
Fee
Rec By
Rec Dt
FOR OFFICE USE ONLY
Activate my Classification - Any required continuing education courses must be posted to your record.
Print New Name:
Change my Name
Inactivate my Classification
Use this name to sign Section D of this application
Classification Holder is deceased - Attach a copy of the obituary or death certificate.
Send a replacement wall certificate and pocket card
Section C
Certification
I hereby authorize a representative of the Georgia Real Estate Appraisers Board to periodically obtain and receive any criminal
history record information and/or full lifetime driver history record information pertaining to me which may be in the files of any
federal, state, or local criminal justice agency.
I hereby certify the information provided in this application is true to the best of my knowledge and belief.
If activating my classification, I hereby agree not to engage in, conduct, advertise, or hold myself out as engaging in or
conducting the business of a state real estate property appraiser in Georgia until I receive my wall certificate.
Appraiser Signature: Date:
