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Georgia Real Estate Commission Georgia Real Estate Appraisers (Georgia Real Estate Commission & Appraisers Board)

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229 Peachtree Street NE
Atlanta, GA 30303-1605
Phone: 404-656-3916
Fax: 404-656-6650
Suite 1000 - International Tower
GREAB (11-2014)
Page 1 of 5
Georgia Real Estate Commission
Georgia Real Estate Appraisers Board
Email: grecmail@grec.state.ga.us
This form can be filled out on-line. Print TWO copies: one to sign and submit for processing and one for your records. Attach the fee and
supporting documentation to the application and mail to the address above. The registration is issued for one (1) year. Once the
completed application, including all supporting documents, is received the registration will be issued. An application requiring background
investigation will require additional time to process. Incomplete applications will be returned unprocessed and result in a $25.00 charge.
Include a non-refundable, registration fee paid by a cashier's check or money order for $1,000.00 made payable to the Georgia Real
Estate Appraisers Board.
Appraisal Management Company Registration Application
Section A
Company Information
Company Name:
FOR OFFICE USE ONLY
REG#
INV
Codes
Proc By & Proc Date
Fee
Rec By
Rec Dt
PLS
PI
Business Address:
City:
Zip Code:
County:
Business Phone Number:
Mailing Address:
City:
State:
Zip Code:
County:
Alternate Phone Number:
E-mail:
For the "Controlling Person" for the Appraisal Management Company, attach a Georgia Criminal Information Center (GCIC) report if you
are a Georgia Resident. If you are not a resident of Georgia, attach a state wide criminal background report from your state of residency.
This report must not be more than 60 days old. A report from a party other than a law enforcement agency is not acceptable. Any incident
listed on the report must receive clearance. In addition, you must disclose any conviction, nolo contendere plea, or first offender sentence
not reflected on the report.
For an "Individual Owner with a direct ownership interest of more than 50% of an Appraisal Management Company" attach a Georgia
Criminal Information Center (GCIC) report if you are a Georgia Resident. If you are not a resident of Georgia, attach a state wide criminal
background report from your state of residency. This report must not be more than 60 days old. A report from a party other than a law
enforcement agency is not acceptable. Any incident listed on the report must receive clearance. In addition, you must disclose any
conviction, nolo contendere plea, or first offender sentence not reflected on the report.
NOTE: List the Company Name under which you will be conducting business in the state of Georgia.
State:
For the "Controlling Person" for the Appraisal Management Company, attach a notarized Lawful Presence Verification form
as detailed on our web site.
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229 Peachtree Street NE
Atlanta, GA 30303-1605
Phone: 404-656-3916
Fax: 404-656-6650
Suite 1000 - International Tower
GREAB (11-2014)
Page 2 of 5
Georgia Real Estate Commission
Georgia Real Estate Appraisers Board
Email: grecmail@grec.state.ga.us
Controlling Person InformationSection B
SSN:
NOTIFICATION OF REQUEST FOR SOCIAL SECURITY ACCOUNT NUMBER (SSAN)
The Georgia Real Estate Commission and Appraisers Board will not release your SSAN to any third party except as required by law.
Alternate Phone Number:
County:
Zip Code:
State:
City:
Mailing Address:
Business Phone Number:
County:
Zip Code:
State:
City:
Residence Address:
Suffix
Last
Name:
Middle
Name:
First
Name:
Birth date
(mm/dd/yyyy)
Female
Male
Each Appraisal Management Company must provide proof of financial responsibility in the form of :
A Surety Bond of not less than $20,000 coverage.
PROVIDE THE FOLLOWING INFORMATION FOR THE SURETY BOND:
Institution Name:
Bond Number:
Section C
Surety Bond
E-mail:
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229 Peachtree Street NE
Atlanta, GA 30303-1605
Phone: 404-656-3916
Fax: 404-656-6650
Suite 1000 - International Tower
GREAB (11-2014)
Page 3 of 5
Georgia Real Estate Commission
Georgia Real Estate Appraisers Board
Email: grecmail@grec.state.ga.us
Background Information
Section D
The Controlling Person Must Answer The Questions Below:
Failure to disclose any conviction, nolo contendere plea, or first offender sentence to a criminal offense, is grounds
for denial of your license. Additional information about the Background Clearance is located on the website at
www.grec.state.ga.us.
(1) In Georgia, or any other state, jurisdiction, or country, have you ever been convicted of, pled nolo contendere to, or been
granted first offender treatment upon being charged with (1) a criminal offense other than a traffic violation or (2) driving under the
influence (DUI) of alcohol or drugs?
You must answer YES to this question even if:
(a) you have been pardoned for the criminal offense;
(b) anyone (lawyer, teacher, broker, government official, etc.) has told you that: (1) the offense is not, or is no longer 'on record', (2) the
offense has been expunged from your record, or (3) you do not have to disclose the offense, (4) your civil and political rights have been
restored, or (5) any similar statement that appears to suggest your 'record' has been cleared; or
(c) the conviction is not reported by the Georgia Crime Information Center (GCIC) or the National Crime Information Center (NCIC).
If YES, you must include the following documents with this application, UNLESS you have already submitted them to
this agency:
(A) For every occurrence (with the exception of a single DUI), provide a certified copy of the citation, accusation, or indictment that led to
the conviction AND a certified copy of the sentence / final disposition. If the court disposition is unavailable, provide a letter from the
court stating the documents are not available.
(B) For every occurrence (including that of a single DUI) provide a detailed written statement that includes:
1) an explanation of the circumstances surrounding every conviction
2) whether you have made any required restitution
3) whether you have completed all conditions of your sentence
4) whether you are on parole or probation (and the date it will end)
YES NO
(2) Have you ever been disciplined by the Georgia Real Estate Commission or the Georgia Real Estate Appraisers Board?
(3) Have you ever been disciplined by any other state or federal licensing agency or authority which regulates any profession?
(Disciplinary actions include, but are not limited to, such actions as: a reprimand, a suspension, a revocation, a fine, or any
restriction placed on a license.)
If you answered "YES" to question (3), you must include the following documents with this application, UNLESS you have
already submitted them to this agency:
(A) For every occurrence, provide a certified copy of the final order from the licensing agency that imposed the disciplinary action.
(B) Provide a detailed written statement that includes:
1) an explanation of the circumstances surrounding the disciplinary action
2) whether you have made any required payment
3) whether you have completed all conditions of your disciplinary action
4) whether your license is currently suspended or revoked
YES NO
YES NO
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229 Peachtree Street NE
Atlanta, GA 30303-1605
Phone: 404-656-3916
Fax: 404-656-6650
Suite 1000 - International Tower
GREAB (11-2014)
Page 4 of 5
Georgia Real Estate Commission
Georgia Real Estate Appraisers Board
Email: grecmail@grec.state.ga.us
The Controlling Person must sign Part (1 ) and then complete Part (2) on the next page.
CertificationSection E
Part (1)
I hereby certify that the Appraisal Management Company has a system and process in place to verify that each appraiser on the
Appraisal Management Company's appraisal panel holds a classification in good standing in the State of Georgia and has not had
a license or classification to act as an appraiser refused, denied, canceled, surrendered in lieu of a pending revocation, or revoked
in any state.
I hereby certify that the Appraisal Management Company includes instructions to appraisers in letters of engagement to decline
the assignment in the event the appraiser is not geographically competent or the assignment falls outside the appraiser's scope of
practice restrictions.
I hereby certify that the Appraisal Management Company has a system in place to review the work of all appraisers who are
performing real estate appraisal services for the Appraisal Management Company on a periodic basis to validate that the real
estate appraisal services are being conducted in conformity with the Uniform Standards of Professional Appraisal Practice and in
accordance with the standards for real estate appraisals established by the Georgia Real Estate Appraisers Board.
I hereby certify that the Appraisal Management Company shall report to the Georgia Real Estate Appraisers Board the results of
any appraisal reviews in which an appraisal is found to be substantially noncompliant with the standards for real estate appraisals
established by the Georgia Real Estate Appraisers Board or any state or federal laws pertaining to appraisals.
I hereby certify that the Appraisal Management Company maintains a detailed record of each service request that it receives for
appraisal services within the State of Georgia and the name, address, and telephone number of the appraiser who performs the
requested real estate appraisal services for the Appraisal Management Company.
I hereby certify that I have read the Georgia Real Estate Appraiser Licensing and Certification Act (O.C.G.A. Chapter 43-39A:
Rules and Regulations Chapter 539) and agree to abide by its provisions in all appraisal activity in the state of Georgia.
I hereby irrevocably consent that, if any cause of action arises against me or arising from my acts or omissions as the Controlling
Person of the Appraisal Management Company within the state of Georgia and if at the time I am not a resident of the state of
Georgia, suit may be commenced against me in the county in the state of Georgia in which said cause of action may arise, or in
which the plaintiff may reside, by the service of process upon the Real Estate Commissioner of the Georgia Real Estate
Appraisers Board, whom I hereby designate for such service; and I further consent that such service shall be begun and held in all
courts to be as valid and binding as if due service had been legally made upon me in the state of Georgia.
I hereby agree that if I am or become a nonresident of the state of Georgia, I will cooperate with any investigation initiated in
accordance with the Official Code of Georgia Annotated §43-39A-22 by promptly supplying any documents that any authorized
representative of the Georgia Real Estate Appraisers Board may request and by personally appearing at the Georgia Real Estate
Appraisers Board's offices or other location in Georgia as the Georgia Real Estate Appraiser Boards' representative may request.
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 understand that after a review of this application and accompanying documents, the Georgia Real Estate Appraisers Board may
require additional information in order to process the application.
I hereby agree not to engage in, conduct, advertise, or hold myself out as engaging in or conducting the business of an Appraisal
Management Company in Georgia until I receive my registration certificate.
Controlling Person Signature:
Date:
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229 Peachtree Street NE
Atlanta, GA 30303-1605
Phone: 404-656-3916
Fax: 404-656-6650
Suite 1000 - International Tower
GREAB (11-2014)
Page 5 of 5
Georgia Real Estate Commission
Georgia Real Estate Appraisers Board
Email: grecmail@grec.state.ga.us
List Names and Address and Contact Information ( attach additional pages if necessary)
Part (2)
You must supply the Name, Address and Contact Information for any individual or any corporation, limited liability company,
partnership, or other business entity that owns 5 percent or more of the Appraisal Management Company applying for this
registration.
Please Note:
(1) For an "Individual Owner with a direct ownership interest of more than 50% of an Appraisal Management Company" attach a
Georgia Criminal Information Center (GCIC) report if you are a Georgia resident. If you are not a resident of Georgia, attach a
state wide criminal background report from your state of residency. This report must not be more than 60 days old. A report from a
party other than a law enforcement agency is not acceptable. Any incident listed on the report must receive clearance. In addition,
you must disclose any conviction, nolo contendere plea, or first offender sentence not reflected on the report.
(2) If as an "Individual Owner with a direct ownership interest of more that 50% of an Appraisal Management Company" you are
disclosing a conviction, nolo contendere plea, or first offender sentence that is not already on file with us, you must also include the
required documents noted in Section D of this application.
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Completed 28 December 2021

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