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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 St Reg (06-2017)
Page 1 of 3
Georgia Real Estate Commission
Georgia Real Estate Appraisers Board
Email: grecmail@grec.state.ga.us
Attach a Georgia Criminal Information Center report (GCIC) if you are a Georgia Resident. If you are not a resident of
Georgia, attach an equivalent 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.
Complete Sections A through E of this application.
Attach any supporting documentation, if required, in Sections C and D.
FOR OFFICE USE ONLY
Rec Dt
Rec By
Fee Proc By & Date Educ
Section A
Individual Information
First
Name:
PID#
SSN:
Email:
Application for State Registered Appraiser
Male
Female
Include a non-refundable, registration fee in the form of a cashier's check or money order for $125.00 made payable to
the Georgia Real Estate Appraisers Board. You will be required to renew by the last day of your birth month in the calendar
year following the calendar year in which you first became registered.
Zip Code
State:
Phone Number:
County:
City:
Residence Address:
Business Number:
County:
Zip Code:
State:
City:
Business Address:
Are you a high school graduate?
High School GED
Last
Name:
Middle
Name:
Active Status
Inactive Status
I am requesting:
LIC#
Suffix
INV
Attach a notarized Lawful Presence Verification form and verifiable identification document. (See www.grec.state.ga.us for form.)
Education - You must have successfully completed, within the 5 year period prior to the submission of this application, the
required 90 hours of core education, which includes passing the 15-hour national USPAP course, to qualify for this
classification. If you completed your coursework at a GREAB Approved School, your courses will be submitted to GREAB
by the School. If you completed your coursework at a school approved in another state, you must include proof of
completion for all required courses.
Birth date:
READ CAREFULLY - Please ensure that your application is complete and that you have answered all questions and included all
required documents. This application requires a fee and must be submitted by mail or in person to the address at the top of this form.
Incomplete applications will be returned unprocessed and result in a $25 charge.
Check this box if Applicant is a Military Spouse or Transitioning Service Member.
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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 St Reg (06-2017)
Page 2 of 3
Georgia Real Estate Commission
Georgia Real Estate Appraisers Board
Email: grecmail@grec.state.ga.us
Background Information
Section B
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 Number:
Zip Code:
State:
City:
Mailing Address:
Number:
Name:
(1) Have you previously held a Georgia appraiser classification?
If Yes:
YES
NO
(2) Have you ever been an appraiser in another state?
YES
NO
Attach a certified appraiser history obtained from the state licensing board or
regulatory agency in the state in which you are an appraiser. This is NOT a
copy of your wall certificate or pocket card. The appraiser history must be
issued within one year of this application.
County:
Fax
Number:
State:
If Yes:
Name:
Number:
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.
Conviction Question
Section C
(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
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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 St Reg (06-2017)
Page 3 of 3
Georgia Real Estate Commission
Georgia Real Estate Appraisers Board
Email: grecmail@grec.state.ga.us
CertificationSection E
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 a state real
property appraiser 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
investigator of the Board may request and by personally appearing at the Board's offices or other location in Georgia as the
Board's investigator 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 a state real
estate property appraiser in Georgia until I receive my wall certificate.
I hereby certify the information provided in this application is true to the best of my knowledge and belief.
Applicant Signature:
Date:
Section D Disciplinary Questions
(1) Have you ever been disciplined by the Georgia Real Estate Commission or the Georgia Real Estate Appraisers Board?
(2) 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 (2), 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
Note: Supervisory Appraisers must register any State Trainee or State Registered appraiser(s) that they are supervising in
order for the supervised appraiser to receive experience credit for the work they performed. The GREAB Appraiser Tracking
System may be accessed by the Supervisory Appraiser by logging into his or her record at www.grec.state.ga.us.
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Georgia Real Estate Commission Georgia Real Estate Appraisers (Georgia Real Estate Commission & Appraisers Board)

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Completed 28 December 2021

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