Fillable Trainee Appraiser Permit Application Checklist (State of New Jersey, Dept. of Law & Pub. Safety, Office of the Attorney General)

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Trainee Appraiser Permit Application Checklist (State of New Jersey, Dept. of Law & Pub. Safety, Office of the Attorney General)

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New Jersey Ofce of the Attorney General
Division of Consumer Affairs
State Real Estate Appraiser Board
124 Halsey Street, 3rd Floor, P.O. Box 45032
Newark, New Jersey 07101
(973) 504-6480
Trainee Appraiser Permit Application Checklist
Information listed below must be submitted with the Trainee Appraiser Permit Application in order
to be processed.
2” x 2” photo: Taken within the past six (6) months.
$100.00 trainee permit fee: Check or money order made payable to: New Jersey State
Real Estate Appraiser Board.
Certication of Supervisor form: Must be signed and notarized.
Education: Course completion certicates (Total of 75 classroom hours completed
within ve (5) years.)
Appraiser Qualications Board (AQB) Course-Tracking Worksheet.
Non-resident consent form: Only submit if applicant does not reside in N.J.
Certication and Authorization form for a Criminal History Background Check.
Certicate of Completion of the Trainee/Supervisor Course: Course required for both
Trainee and Supervising Appraiser to complete.
New Jersey Ofce of the Attorney General
Division of Consumer Affairs
State Real Estate Appraiser Board
124 Halsey Street, 3rd Floor, P.O. Box 45032
Newark, New Jersey 07101
(973) 504-6480
Trainee Appraiser Permit Application
Instructions
Note: Please review the enclosed copy of Board regulations governing the Trainee Appraiser Permit Program
(N.J.A.C. 13:40A-4).
1. Please type or print clearly. Your application must be signed and notarized in order to be processed.
2. Each question must be completed in its entirety. Questions not applicable should be so indicated by
entering “N/A.” If additional space is required for any of the questions, attach additional pages using the
same format as the space provided.
3. Applicants are required to submit all education course completion certicates and the Appraiser
Qualications Board (AQB) Course-Tracking worksheet listed in conjunction with this application.
4. Incomplete applications will be returned to you and delay consideration of your application and the
issuance of your trainee permit. Make sure to include the $100.00 annual trainee permit fee with your
application. Remittance must be in the form of a check or money order made payable to “New Jersey
State Real Estate Appraiser Board.”
5. The application form must include a designation of the certied individual who will agree to serve as
your “supervising appraiser.” Regulations require that this individual acknowledge this responsibility in
writing by completing the Certication of Supervising Appraiser form.
6. As of January 1, 2015, prior to submitting an application for trainee appraiser, both the trainee appraiser
and supervisory appraiser are required to complete the Trainee/Supervisor Course. A Certicate of
Completion of the course must be attached with the application for both the trainee appraiser and the
supervisory appraiser, as well as for any subsequent supervisory appraisers obtained.
7. Regulations also require that you notify the Board in writing, within seven (7) days in the event that a
designated “supervising appraiser” ceases to agree to perform this function on your behalf. A trainee
appraiser is permitted a maximum of three (3) supervisors, each of whom must be identied to this Board.
Please also note that Board regulations require that the supervisor(s) supply you with a copy of any
appraisal report in which you participate.
Note: You must return your permit within 30 days in the event you no longer have direct supervision.
8. The trainee shall maintain a log on the forms supplied by the Board. These forms may be reproduced.
The log will be used to record work performed by the trainee toward the fullling of the experience
requirement for licensure or certication. The supervising appraiser is required to sign off on log entries
at least monthly. Trainees must maintain a separate log for each individual designated as a “supervising
appraiser.”
9. The trainee shall ensure that the log is available at all times for the Board’s inspection.
10. Upon renewal, trainees will be required to submit the log for the Board’s review. Trainees should be sure
that they put a check in the appropriate boxes to indicate their level of participation in the appraisals listed
in the log.
11. When performing appraisal assignments, trainees are required to carry the wallet card issued by the Board
that indicates their permit number.
Any questions regarding the trainee program should be directed to the Board ofce at 973-504-6480.
"TRAINEE" COURSE TRACKING WORKSHEET
Hours
Required
Hours
Completed
30
Course Name Provider
Date
Completed
Basic Real Property Concepts
Real Property Characteristics
Legal Description (Physical)
Forms of Ownership
Public and Private Controls
Real Estate Contracts
Leases
Governmental
Economic
Social
Environmental, Geographic and Physical
Market Value
Other Value Types
Classic Economic Principles
Application and Illustrations of the
Economic Principles
Real Property Concepts and Characteristics
Legal Consideration
Influences on Real Estate Values
Types of Value
Core Curriculum Content
BASIC APPRAISAL PRINCIPLES
Information on Course(s) Completed
Gray Shaded Boxes = Required Core Curriculum Modules Effective 1/1/2008
Boxes without shading = Subtopics within Required Core Curriculum
Economic Principles
Overview of Real Estate Markets and Analysis
"Trainee" Course Tracking Worksheet
Page 1 of 3
"TRAINEE" COURSE TRACKING WORKSHEET
Hours
Required
Hours
Completed
Core Curriculum Content
Information on Course(s) Completed
Market Fundamentals, Characteristics and
Definitions
Supply Analysis
Demand Analysis
Use of Market Analysis
30
Course Name Provider
Date
Completed
Defining the Problem
Collecting and Selecting Data
Analyzing
Reconciling and Final Value Opinion
Communicating the Appraisal
Geographic Characteristics of the Land/Site
Geologic Characteristics of the Land/Site
Location and Neighborhood Characteristics
Land/Site Considerations for Highest and
Best Use
Improvement - Architectural Styles and
Types of Construction
BASIC APPRAISAL PROCEDURES
Valuation Procedures
Property Description
Residential Applications
Ethics and How They Apply in Appraisal Theory
and Practice
Examination
Overview of Approaches to Value
"Trainee" Course Tracking Worksheet
Page 2 of 3
"TRAINEE" COURSE TRACKING WORKSHEET
Hours
Required
Hours
Completed
Core Curriculum Content
Information on Course(s) Completed
15
Course Name Provider
Date
Completed
Preamble and Ethics Rules
Standard 1
Standard 2
Standards 3 to 10
Statements and Advisory Opinions
Examination
75
THE 15-HOUR NATIONAL USPAP COURSE OR
ITS EQUIVALENT
TRAINEE TOTAL HOURS REQUIRED
Examination
"Trainee" Course Tracking Worksheet
Page 3 of 3
Division of Consumer Affairs
State Real Estate Appraisers Board
124 Halsey Street, 3
rd
Floor
P.O. Box 45032, Newark, NJ 07101
(973) 504-6480
New Jersey Is An Equal Opportunity Employer • Printed on Recycled Paper and Recyclable
Dear Trainee Permit Applicant:
Please have your supervising appraiser complete the attached supervisor
certification.
The enclosed Evaluation Certification form, Competency Certification form and Trainee
Assistance form are provided for your supervisor to complete as required.
Should you have any questions, please feel free to contact this office at (973) 504-6480.
Very truly yours,
State Real Estate Appraisers Board
Enclosure
CERTIFICATION OF SUPERVISING APPRAISER
Trainee Name:
The individual above has applied for a Trainee Appraiser Permit and designated you as a
SUPERVISING APPRAISER pursuant to N.J.A.C. 13:40A-4.6. Board regulations require
that you acknowledge this responsibility in writing; the full text of those regulations is listed
below.
§ 13:40A-4.6 Responsibilities of supervising appraiser
(a) Any individual designated as a "supervising appraiser" by the holder of a trainee permit shall
acknowledge in writing to the Board that he or she agrees to perform all responsibilities set forth in (f) below.
(b) Supervising appraisers shall be in good standing with the Board and shall not have been subject to
any disciplinary action, including revocation, suspension, or stayed suspension, by the Board, within the last
three years from the beginning of the supervision.
© No appraiser shall serve as a supervising appraiser until he or she has been a licensee of the Board
for at least two years.
(d) Beginning on January 1, 2008, licensed real estate appraisers shall no longer be approved to serve
as supervising appraisers. Beginning on February 5, 2007, the Board will no longer accept applications by
trainees who seek approval of a licensed real estate appraiser as a supervising appraiser.
(e) Beginning on January 1, 2008, only those individuals who are certified by the Board as either a State
certified general real estate appraiser or a State certified residential real estate appraiser shall be a
supervising appraiser.
(f) A supervising appraiser shall have the following duties and responsibilities:
1. The supervising appraiser shall at all times be responsible for and provide direct supervision of the work
performed by the trainee. For purposes of this section, "direct supervision" means:
I. To personally review the work product of the trainee;
ii. To approve, sign, and accept responsibility for each appraisal report including work product prepared
by the trainee or in which the trainee has made a professional contribution and to sign all such reports and
certify that all such reports have been independently and impartially prepared in compliance with the Uniform
Standards of Professional Appraisal Practice, these rules and applicable statutory standards; and
iii. To indicate, within the certification section of the appraisal report, the name of the trainee providing
significant real property appraisal assistance. For purposes of this subparagraph, "significant" means the
exercise of appraisal knowledge and training and does not mean clerical or fact gathering tasks.
2. The supervising appraiser shall, at least once a month, sign the log required to be kept by the trainee
pursuant to
N.J.A.C. 13:40A-4.7
and shall set forth thereon his or her license or certification number.
3. The supervising appraiser shall provide the trainee with a copy of any final appraisal report in which the
trainee's work product has been utilized or in which the trainee made a professional contribution.
4. The supervising appraiser shall immediately notify the Board and his or her trainee(s), in writing, in the
event that he or she ceases to perform or is unable to perform the responsibilities set forth in this section.
5. A supervising appraiser shall not supervise more than three trainees at one time;
6. The supervising appraiser shall personally inspect, with the trainee, the interior and exterior of each
appraised property until the supervising appraiser determines that the trainee is competent in accordance with
the Competency Rule of the Uniform Standards of Professional Appraisal Practice. Upon making the
determination of competency, the supervising appraiser shall request a competency certification form from
the Board. The supervising appraiser shall submit, to the Board, within 30 days of receipt of the competency
certification form, the certification that the trainee is competent to perform property inspections independently.
Examples of competency include, but are not limited to, properly identifying the problem to be addressed,
being familiar with a specific type of property, market, geographic area, or analytical method.
7. The supervising appraiser shall prepare and furnish a signed statement describing the nature and
extent of the assistance rendered to each trainee who provided services on an appraisal assignment. This
statement shall be placed in the work file of the appraisal assignment.
8. Upon the termination of the supervising appraiser and the trainee relationship, the supervising appraiser
shall request an evaluation certification form from the Board. The supervising appraiser shall submit, to the
Board, within 30 days of receipt of the evaluation certification form, the certification evaluating the activities
performed by his or her trainee.
9. Failure to comply with this section may be deemed professional misconduct.
You are also reminded of your responsibilities under Uniform Standards of Professional Appraisal
Practice standards rule 2-5, "An appraiser who signs a real property appraisal report prepared by
another, even under the label of 'review appraiser', must accept full responsibility for the contents
of the report."
Pursuant to all applicable laws and regulations of the New Jersey Board of Real Estate Appraisers,
I hereby accept designation as a Supervising Appraiser for the above-captioned trainee in his/her
capacity as holder of a Trainee Permit issued by the Board of Real Estate Appraisers. I have read
and understand my responsibilities under these rules and the Uniform Standards of Professional
Appraisal Practice.
__________________________________ ___________________________
(Name of Appraiser) (License/Certification Number)
__________________________________
(Signature of Appraiser)
Sworn and subscribed to before me this _________ day of _____________________, 20____
________________________________
(Name of Notary Public)
AFFIX ________________________________
(Signature of Notary Public)
SEAL HERE
My commission expires: ____________
County ____________ State________
revised 1/1/08supervisor form.wpd
EVALUATION CERTIFICATION FORM
I, (
) have been a designated supervisor of ( )
Name of supervisor Name of trainee
(
)
. The termination of the supervising appraiser and trainee relationship was
trainee permit number
effective on ( / /
). Pursuant to N.J.A.C. 13:40A-4.6(8) this certification is an evaluation of the
date
activities performed by the trainee.
Satisfactory Unsatisfactory Not Applicable/Comments
Understands USAP Goals
Identifying Scope of Work Required
Research of Subject Property
Relevant Characteristics
Sales History
Contract of Sale (when applicable)
Survey/Tax Map
Applicable Zoning
Cost Approach
Building Costs
Age/Life Factors
Contribution of the Land
Sources of Depreciation
Sales Comparison Approach
Identification of Neighborhood
Location Variables
Selection of Comparable Properties
Market Conditions/Financing Factors
Gross Rent Multipliers
Acceptable Adjustment Methodology
Income Approach
Lease Agreements/Market Rent
Development of Net Operating Income
Capitalization Rates/Methodology
Reconciliation
Competent Analysis of Data Collection
Ability to Express Analysis
Certification Requirements
Record Keeping
Understands USPAP Requirements
Signature of Supervisor:__________________________________ Date: ________________
NEW JERSEY STATE BOARD OF REAL ESTATE APPRAISERS
COMPETENCY CERTIFICATION FORM
Pursuant to
N.J.A.C
13:40A-4.6 (6)
the supervising appraiser shall submit, to the Board, within 30 days
of the receipt of the competency certification form, the certification that the trainee is competent to
perform property inspections independently.
I,
have been a designated supervisor of
Name of supervisor Name of Trainee
. I have personally inspected the interior and exterior of
Trainee Number Number of properties
appraised with the aforementioned trainee and I have determined that the trainee is competent in
accordance with the Competency Rule of the Uniform Standards of Professional Appraisal Practice
to perform property inspections independently. (Examples of the competency include, but are not
limited to properly identifying the problem to be addressed, being familiar with a specific type of
property, market, geographic area, or analytical method).
_______________________________ ___________________________
Name of Supervisor (Print) Certification Number
_______________________________ ___________________________
Signature of Supervisor Date
NEW JERSEY BOARD OF REAL ESTATE APPRAISERS
TRAINEE NAME:________________________________________
CHECK A LL THAT APPLY
TRAINEE PERMIT NO.:__________________________________
I. Land / Site
Inspection & Descriptions
II. Building
Inspection & Descriptions
III. Neighborhood Description
& Analysis
IV. Highest & Best
Use Analysis
V. Research & Analysis of
Comparable Sales
VI. Cost Analysis
VII. Income Analysis
VIII. Sales Adjustment Analysis
IX. Correction / Reconciliation
Of Data- Final Value
Appraisal Location & Address of City and State of Name of Type of Property Intent Use of The
Date Appraised Property Appraised Property Client Appraised Appr. Report
1/1/0000 000 Halsey Street Newark, NJ Appraisal Bank Multi Family Purchase
Check the appropriate boxes to describe the nature and extent of the assistance rendered by each
trainee who provided services on the appraisal assignment.
Pursuant
t
o N.J.A.C. 13:40A-4.6
(
7
)
this si
g
ned statement shall be placed in the work file of the appraisal assi
g
nment.
Supervisor Signature:_______________________________Certification Number:________________________Date:________________
Supervisor Name: (PRINT )_____________________________
New Jersey Ofce of the Attorney General
Division of Consumer Affairs
State Real Estate Appraiser Board
124 Halsey Street, 3rd Floor, P.O. Box 45032
Newark, New Jersey 07101
(973) 504-6480
Trainee Appraiser Permit Application
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Please print clearly. You must answer all of the questions on this application.
Personal Information
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
    
 
 
 

 

    
  
    

˝˝


   

    

For Ofce Use Only
 
  
   
  

Nonrefundable application fee
(check or money order)
Trainee permit fee
....................$100
3. Social Security Number
You must disclose your Social Security number to the Board or Committee. Failure to do so may result in denial/nonrenewal of
licensure or certication.
*Social Security Number: __________- _________ - _________
*Pursuant to N.J.S.A. 54:50-24 et seq. of the New Jersey taxation law, N.J.S.A. 2A:17-56.44e of the New Jersey Child Support
Enforcement Law, Section 1128E(b)(2)A of the Social Security Act and 45 C.F.R. 60.7, 60.8 and 60.9, the Board or Committee is
required to obtain your Social Security number. Pursuant to these authorities, the Board or Committee is also obligated to provide
your Social Security number to:
a. the Director of Taxation to assist in the administration and enforcement of any tax law, including for the purpose of reviewing
compliance with State tax law and updating and correcting tax records; and
b. the Probation Division or any other agency responsible for child support enforcement, upon request.
4. Citizenship / Immigration Status
Federal law limits the issuance or renewal of professional or occupational licenses or certicates to U.S. citizens or qualied aliens.
To comply with this federal law, check the appropriate box below which indicates your citizenship/immigration status. If you are not
a U.S. citizen, attach a copy of your alien registration card (front and back) or other documentation issued by the ofce of U.S.
Citizenship and Immigration Services (USCIS).
U.S. citizen
Alien lawfully admitted for permanent residence in U.S.
Other immigration status
Questions about your immigration status and whether or not it is a qualifying status under federal law should be directed to the
USCIS at: 1-800-375-5283.
5. Student Loan
Are you in default in regard to any student loan obligation(s)? Yes No
If “Yes,” you must obtain documentary evidence that you have reached an arrangement with the bank or with the entity that issued
your student loan, for the eventual repayment of the loan. You will not be able to obtain a license or certicate unless you provide the
required documents concerning the plan for repayment of your student loan.
6. Child Support
Please certify, under penalty of perjury, the following:
a. Do you currently have a child-support obligation? Yes No
(1) If “Yes,” are you in arrears in payment of said obligation? Yes No
(2) If “Yes,” does the arrearage match or exceed the total amount payable for the past six months? Yes No
b. Have you failed to provide any court-ordered health insurance coverage during the past six months? Yes No
c. Have you failed to respond to a subpoena relating to either a paternity or child-support proceeding? Yes No
d. Are you the subject of a child-support-related arrest warrant? Yes No
In accordance with N.J.S.A. 2A:17-56.44d, an answer of “Yes” to any of the questions a(1) through d may result in a denial of
licensure or certication. Furthermore, any false certication of the above may subject you to a penalty, including, but not limited
to, immediate revocation or suspension of licensure or certication.
___________________________________ ___________________________________ _______________________
Applicant’s name (please print) Applicant’s signature Date
7. Medical Conditions Questions
Questions 18 through 23 pertain to medical conditions and use of chemical substances. Please read the denitions carefully. Your
responses will be treated condentially and retained separately. Please be aware that you have the right to elect not to answer those
portions of the following questions which inquire as to the illegal use of controlled dangerous substances or activity if you have
reasonable cause to believe that answering may expose you to the possibility of criminal prosecution. In that event, you may assert the
Fifth Amendment privilege against self-incrimination. Any claim of Fifth Amendment privilege must be made in good faith. If you
choose to assert the Fifth Amendment, you must do so in writing. You must fully respond to all other questions on the application.
Your application for licensure will be processed if you claim the Fifth Amendment privilege against self-incrimination. You should
be aware, however, that you may later be directed by the Attorney General to answer a question that you have refused to answer
on the basis of the Fifth Amendment, provided that the Attorney General rst grants you immunity afforded by statutory law.
(N.J.S.A. 45:1-20.)
“Ability to practice as a real estate appraiser trainee” is to be construed to include all of the following:
a. The cognitive capacity to exercise the reasonable judgments of a real estate appraiser trainee and to learn and keep abreast of pro-
fessional developments; and
b. The ability to communicate those judgments and related information to clients and other interested parties, with or without the
use of aids or devices, such as voice ampliers; and
c. The physical capability to perform the duties of a real estate appraiser trainee, with or without the use of aids or devices, such as
corrective lenses or hearing aids.
“Medical Condition” includes physiological, mental or psychological conditions or disorders, such as, but not limited to orthope
dic,
visual, speech and hearing impairments, cerebral palsy, epilepsy, muscular dystrophy, multiple sclerosis, cancer, heart disease,
dia
betes, mental retardation, emotional or mental illness, specic learning disabilities, H.I.V. disease, tuberculosis, drug addiction
and alcoholism.
“Chemical substance” is to be construed to include alcohol, drugs or medications, including those taken pursuant to a valid
pre
scription for legitimate medical purposes and in accordance with the prescriber’s direction, as well as those used illegally.
“Currently” does not mean on the day of, or even in the weeks or months preceding the completion of this application. Rather,
it means recently enough so that the use of drugs may have an ongoing impact on one’s functioning as a licensee, or within the
previous two years.
“Illegal use of controlled dangerous substance” means the use of a controlled dangerous substance obtained illegally (e.g. heroin
or cocaine) as well as the use of controlled dangerous substances which are not obtained pursuant to a valid prescription or not taken
in accordance with the directions of a licensed health care practitioner.
a. Do you have a medical condition which in any way impairs or limits your ability to practice your profession with reasonable
skill and safety? Yes No
b. Are the limitations or impairments caused by your medical condition reduced or ameliorated because you receive ongoing
treatment (with or without medications) or participate in a monitoring program**?
Yes No Not applicable
c. Are the limitations or impairments caused by your medical condition reduced or ameliorated because of the eld of practice,
the setting or manner in which you have chosen to practice? Yes No Not applicable
d. Does your use of chemical substance(s) in any way impair or limit your ability to practice your profession with reasonable skill
and safety? Yes No Not applicable
e. Have you ever been diagnosed as having or have you ever been treated for pedophilia, exhibitionism or voyeurism?
Yes No
f. Are you currently engaged in the illegal use of controlled dangerous substances? (Recall that “currently” is dened as “within
the last two years.”) Yes No
If you answered “Yes” to question f, are you currently participating in a supervised rehabilitation program or professional
assistance program which monitors you in order to assure that you are not engaging in the illegal use of controlled dangerous
substances? Yes No
** If you receive such ongoing treatment or participate in such a monitoring program, the Board or Committee will make an
individualized assessment of the nature, the severity and the duration of the risks associated with an ongoing medical condition so
as to determine whether an unrestricted license or certicate should be issued, whether conditions should be imposed or whether
you are not eligible for licensure or certication.
____________________________________________________ ___________________________________
Signature of applicant Date
8. Have you ever changed your name? Yes No
If “Yes,” please submit with this application a copy of the marriage certicate, divorce decree or court order.
9. Have you ever been summoned; arrested; taken into custody; indicted; tried; charged with; admitted into pre-trial intervention (P.T.I.);
or pled guilty to any violation of law, ordinance, felony, misdemeanor or disorderly persons offense, in New Jersey, any other state,
the District of Columbia or in any other jurisdiction? (Parking or speeding violations need not be disclosed, but motor vehicle
violations such as driving while impaired or intoxicated must be.) Yes No
10. Have you ever been convicted of any crime or offense under any circumstances? This includes, but is not limited to, a plea of guilty,
non vult, nolo contendere, no contest, or a nding of guilt by a judge or jury. Yes No
If “Yes,” provide a copy of the judgment of conviction and the release from parole or probation. Please provide a complete explanation.
(Attach additional sheets of paper to this application.)
11. Do you currently hold, or have you ever held, a professional license, certicate or permit of any kind in New Jersey, any other state, the
District of Columbia or in any other jurisdiction? Yes No
If “Yes,” for each license, certicate or permit held, provide the date(s) held and the number(s). If the license or certicate was issued under
a different name, please proivde that name.
Last name First name Middle initial
_____________________ _______________________ _____________________________ ____________________
Type of license, certicate or permit Number State or jurisdiction that issued the license, certicate or permit Date issued/expired
_____________________ _______________________ _____________________________ ____________________
Type of license, certicate or permit Number State or jurisdiction that issued the license, certicate or permit Date issued/expired
_____________________ _______________________ _____________________________ ____________________
Type of license, certicate or permit Number State or jurisdiction that issued the license, certicate or permit Date issued/expired
_____________________ _______________________ _____________________________ ____________________
Type of license, certicate or permit Number State or jurisdiction that issued the license, certicate or permit Date issued/expired
12. Have you ever been disciplined or denied a professional license, certicate or permit of any kind in New Jersey, any other state, the
District of Columbia or in any other jurisdiction? Yes No
13. Have you ever had a professional license, certicate or permit of any type suspended, revoked or surrendered in New Jersey, any
other state, the District of Columbia or in any other jurisdiction? Yes No
14. Has any action (including the assessment of nes or other penalties) ever been taken against your professional practice by any agency
or certication board in New Jersey, any other state, the District of Columbia or in any other jurisdiction? Yes No
15. Have you ever been named as a defendant in any litigation related to the practice of real estate appraisal training or other professional
practice in New Jersey, any other state, the District of Columbia or in any other jurisdiction? Yes No
16. Are you aware of any investigation pending against a professional license, certicate or permit issued to you by a professional board
in New Jersey, any other state, the District of Columbia or in any other jurisdiction? Yes No
17. Are there any criminal charges now pending against you in New Jersey, any other state, the District of Columbia or in any other
jurisdiction? Yes No
18. Have you ever been sanctioned by or is any action pending before any employer, association, society, or other professional group
related to the practice of real estate appraisal training or other professional practice in New Jersey, any other state, the District of
Columbia or in any other jurisdiction? Yes No
If the answer to any of the above questions, numbers 12 through 18, is “Yes,” provide a complete explanation of the circumstances
leading to the action, and any supporting documentation, on separate sheets of paper.
High School Education
I was graduated from ________________________________________________________________________________
School name
_________________________________________________ in _____________________________ , _______________.
City and State Month Year
Undergraduate Education
List in chronological order any college, university or institution of higher learning that you have attended.
Degree
Months and Years Name of institution (if any)
______ / ______ to ______ / ______ _____________________________________________ ________________
______ / ______ to ______ / ______ _____________________________________________ ________________
______ / ______ to ______ / ______ _____________________________________________ ________________
______ / ______ to ______ / ______ _____________________________________________ ________________
Postgraduate Education
List in chronological order any college, university or institution of higher learning that you have attended.
Degree
Months and Years Name of institution (if any)
______ / ______ to ______ / ______ _____________________________________________ ________________
______ / ______ to ______ / ______ _____________________________________________ ________________
______ / ______ to ______ / ______ _____________________________________________ ________________
______ / ______ to ______ / ______ _____________________________________________ ________________
Uniform Standards of Professional Appraisal Practice Course (U.S.P.A.P.)
The 15-hour National U.S.P.A.P. course must be completed within 60 months prior to the ling of the application. List the course here and
under “Appraisal Education” on the next page. (Please attach any supporting documentation to this application.)
Date Course Classroom
Course title Provider or course sponsor completed hours hours
__________________________ ____________________________________ _________________ ________ _______
Appraisal Education
List all of the appraisal qualifying education courses that you have successfully completed which consisted of at least 15 classroom
hours and included an examination. Attach all course completion certicates to this application. Courses will not be considered without proper
documentation. (Use additional sheets of paper if necessary.)
Date Course Classroom
Course title Provider or course sponsor completed hours hours
__________________________ ____________________________________ _________________ ________ _______
__________________________
____________________________________ _________________ ________ _______
__________________________
____________________________________ _________________ ________ _______
__________________________
____________________________________ _________________ ________ _______
__________________________
____________________________________ _________________ ________ _______
__________________________
____________________________________ _________________ ________ _______
__________________________
____________________________________ _________________ ________ _______
__________________________
____________________________________ _________________ ________ _______
__________________________
____________________________________ _________________ ________ _______
__________________________
____________________________________ _________________ ________ _______
__________________________
____________________________________ _________________ ________ _______
__________________________
____________________________________ _________________ ________ _______
Supervising Appraiser
The following New Jersey certied appraiser(s) has/have agreed to be designated as a “supervising appraiser” for the purposes of this
program.
Note: Trainees are required to notify the Board ofce of the names of all of their supervisors.
1. _____________________________________________________________________________________________________
Name of appraiser License/Certicate number Telephone number (include area code)
_____________________________________________________________________________________________________
Street address City State ZIP code
2. _____________________________________________________________________________________________________
Name of appraiser License/Certicate number Telephone number (include area code)
_____________________________________________________________________________________________________
Street address City State ZIP code
Supervising Appraiser (continued)
3. _____________________________________________________________________________________________________
Name of appraiser License/Certicate number Telephone number (include area code)
_____________________________________________________________________________________________________
Street address City State ZIP code
4. _____________________________________________________________________________________________________
Name of appraiser License/Certicate number Telephone number (include area code)
_____________________________________________________________________________________________________
Street address City State ZIP code
5. _____________________________________________________________________________________________________
Name of appraiser License/Certicate number Telephone number (include area code)
_____________________________________________________________________________________________________
Street address City State ZIP code
affidavit
This afdavit is to be executed by the applicant before a notary public:
State of: ______________________________________
County of: ____________________________________
I, ___________________________________________ , in making this application to the State Real Estate Appraiser Board
for a permit, license or certicate to practice as a real estate appraiser under the provisions of Title 45 of the General Statutes
of New Jersey and the Rules of the State Real Estate Appraiser Board, swear (or afrm) that I am the applicant and that all
information provided in connection with this application is true to the best of my knowledge and belief. I understand that any
omissions, inaccuracies or failure to make full disclosures may be deemed sufcient to deny a permit, license or certicate
or to withhold renewal of or suspend or revoke a permit, license or certicate issued by the Board.
I further swear (or afrm) that I have read N.J.S.A. 45:14F-1 et seq., together with the Rules and Regulations of the State Real
Estate Appraiser Board, N.J.A.C. 13:40A-1.1 et seq., and fully understand that in receiving a permit, license or certicate
from the Board, I bind myself to be governed by them.
Furthermore, I voluntarily consent to a thorough investigation of my present and past employment and other activities for
the purpose of verifying my qualications for a permit, license or certicate. I further authorize all institutions, employers,
agencies and all governmental agencies and instrumentalities (local, state, federal or foreign) to release any information, les
or records requested by the Board.
_________________________________________
Signature of applicant
Sworn and subscribed to before me this _____________
day of _________________________ , ____________
Month Year
_____________________________________________
Name of Notary Public (please print)
_____________________________________________
Signature of Notary Public
Afx seal
here
New Jersey Office of the Attorney General
Division of Consumer Affairs
State Real Estate Appraisers Board
124 Halsey Street, 3
rd
Floor, PO Box 45032
Newark, New Jersey 07102
March 2009
A. ACCEPTABLE PROFESSIONAL ORGANIZATIONS
Appraisal Institute American Society of Farm Managers
550 W. Van Buren Street and Rural Appraisers
Suite 1000 950 South Cherry Street - Ste 508
Chicago IL 60607 Denver CO 80246
Phone: (312) 355-4100 Phone: (303) 692-1
222
F
ax: (312) 355-4400 Fax: (303) 758-0190
w
ww.appraisalinstitute.org
E-mail: dilk@asfmra.org
www.asfmra.org
National Association of The American Society of Appraisers
Independent Fee Appraisers (
Northern NJ Chapter
) Chapter #73
401 North Michigan Avenue, Ste 2200 President: Rafino Fernandez
Chicago IL 60611 354 Eisenhower Parkway
e-mail: info@naifa.com
Phone: (312) 321-6830
www.naifa.com
Livingston NJ 07039
Fax: (312) 673-6652
Phone: (201) 866-8101
Phone #2: (800) 272-8258
Fax: (201) 956-6268
http://www.asanj.com
International Association of International Right of Way
Assessing Officers Association
130 East Randolph - Ste 850 13650 S. Gramercy Place
Chicago IL 60601 Gardena CA 90249-2453
Phone: (312) 819-6100 Phone: (310) 538-0233
Fax: (312) 819-6149 Fax: (310) 538-1471
American Association of Ben Henson
Certified Appraisers Executive Director
800 Compton Road - Ste 10 Appraisal Sub Committee
Cincinnati OH 45231 2000 K Street, NW, Suite 310
Phone: (513) 729-1400 Washington DC 20006
David Bunton American Society of Appraisers
Appraisal Foundation (
Northern NJ Chapter
)
1029 Vermont Avenue, N.W. Ex. Dir. Stacey Klein
Washington , DC 20005 5-15 Elizabeth Street
Fair Lawn NJ 07410
New Jersey Office of the Attorney General
Division of Consumer Affairs
State Real Estate Appraisers Board
124 Halsey Street, 3
rd
Floor, PO Box 45032
Newark, New Jersey 07102
March 2009
B. ACCEPTABLE EDUCATIONAL PROGRAMS AT COLLEGES/UNIVERSITIES
Bergen Community College Thompson CompuTaught, Inc. d.b.a. Web School
400 Paramus Road Cumberland Center II
Paramus NJ 07652 3100 Cumberland Blvd. - Suite 1450
Phone: (201) 447-7100 Atlanta, GA 30339
http://www.go.bergen.edu Phone: (800) 532-7649
Fax: (770) 919-9979
www.careerwebschool.com
Fairleigh Dickinson University Professional School of Business
1000 River Road 22 East Willow Street
Teaneck NJ 07666 Millburn NJ 07041
Phone: (201) 692-2000 Phone: (973) 564-8686
www.fdu.edu Fax: (973) 564-8982
www.proschool.com
Mercer County Community College Rutgers University, Connie Burke
P.O. Box B Center of Government Services
Trenton NJ 08690 33 Livingston Ave - Ste 200
Phone:(609) 586-4800 New Brunswick NJ 08901
www.mccc.edu Phone: (732) 932-3640 ext. 627
American School of Business National Residential
194-198 Route 46 East Appraisers Institute
Fairfield NJ 07004-2398 2001 Cooper Foster Park Rd.
Phone: (973) 244-0333 Amherst OH 44001
Fax: (973) 244-0246 Phone: (440) 282-7925
www.americanschoolnj.com
Union County College North Jersey School of Real Estate
1033 Springfield Avenue 212 Durham Avenue
Cranford NJ 07016 Metuchen NJ 08840
Phone: (908) 709-7000 Phone: (732) 548-0603
www.ucc.edu Fax: (732) 548-0787
Business Learning Center Renwick & Associates
184 Rt 35 Valuation Solutions
Cliffwood Beach NJ 07735 104 E. Main Street
Phone:(732) 290-9269 Maple Shade NJ 08052
Phone: #2 1-800-769-9167 Phone: (856) 779-7050
E-mail: georgeyager@ptonline.net www.renwickandassociates.com
The Chicopee Group
1579 Thalia Street
Youngstown OH 44514
Phone: (800) 644-3754
New Jersey Ofce of the Attorney General
Division of Consumer Affairs
State Real Estate Appraisers Board
124 Halsey Street, 3
rd
Floor, PO Box 45032
Newark, New Jersey 07102
New Jersey Office of the Attorney General
Division of Consumer Affairs
State Real Estate Appraisers Board
124 Halsey Street, 3
rd
Floor, PO Box 45032
Newark, New Jersey 07102
March 2009
D. ACCEPTABLE EDUCATIONAL PROGRAMS CONT’D
South Jersey Professional School De Fluri Institute of Real Estate & Appraisal
of Business, Inc. and 119 West King Street
the Insurance School Hillside NJ 07205
331 Tilton Road, Suite Phone: (908) 241-8008
34Tilton Shopping Center Fax: (908) 241-8008
P.O. Box 1112 E-mail: deflurijr@verizon.net
Northfield NJ 08225
Phone: (609) 646-3170
Fax: (609) 646-3336
http://professionalbusinessschool.com
New Jersey Office of the Attorney General
Division of Consumer Affairs
State Real Estate Appraisers Board
124 Halsey Street, 3
rd
Floor, PO Box 45032
Newark, New Jersey 07102
March 2009
E. NEW JERSEY/NORTHEAST CHAPTERS
Appraisal Institute Appraisal Institute
(
Southern NJ
) (
Southern NJ
)
J. Paul Bainbridge Lisa Weiss
JP Bainbridge & Associates, Inc. 43 Crescent Hollow Drive
300 Goshen Road Sewell NJ 08080
Cape May Court House, NJ 08210 Phone: (856) 415-0281
Phone: (609)465-9978 Fax: (856) 415-1952
www.ai-snj.org
International Association of Camden NAIFA Chapter
Assessing Officers 442 Buttenwood Avenue
Phone: (609) 465-1030 Mapleshade, NJ 08052
Phone: (609)263-5995
Appraisal Institute Appraisal Institute
(
Metro NJ Chapter
) (
Metro NJ Chapter
)
P. O. Box 2000 Aurora Loan
295 Pierson Avenue Services/Lehman Brothers
Edison NJ 08818 230 Park Avenue
Debra J. Miller Florham Park NJ 07932
Executive Secretary Denise Smith
appraisal.institute@verizon.net President
http://www.ai-newjersey.org Phone: (973) 261-1557
Executive Secretary Fax: (973) 261-1882
(732) 494-4640-Fax
The Mortgage Bankers Association The New Jersey Association of Realtors
of New Jersey/League of Mortgage 295 Pierson Avenue
Lenders Edison NJ 08818
P.O. Box 309 385 Morris Avenue
Springfield NJ 07081 Phone: (732) 494-5616
Independent Fee Appraisers Independent Fee Appraisers
Regional Governor State Director
Charles Blau, IFAC Louis A. Bonato, IFA
55 Morris Avenue 22 Mockingbird Lane
Springfield NJ 07081 Petersburg NJ 08270
Phone: (973) 564-9001 Phone: (609) 628-3340
Fax: (973) 564-9071 Fax: (609) 628-2953
NEW JERSEY BOARD OF REAL ESTATE APPRAISERS Page_____ of _____
License/Trainee Appraisal Log
CHECK ALL THAT APPLY T = Trainee Participation S= Supervisor Participation
APPLICANT NAME:__________________________________
TRAINEE PERMIT/LICENSE NO.____________________
_
I. Land / Site
Inspection & Descriptions
Scope of Review
II. Building
Inspection & Descriptions
Scope of Review
III. Neighborhood Description
& Analysis
Scope of Review
IV. Highest & Best
Use Analysis
Scope of Review
V. Research & Analysis of
Comparable Sales
Scope of Review
VI. COST ANALYSIS
Scope of Review
VII. Income Analysis
Scope of Review
VIII. Sales Adjustment Analysis
Scope of Review
IX. Correction / Reconciliation
Of Data- Final Value
Scope of Review
Amount
Appraisal
Address of City and State of Name of Type of
Intended Use
T S S T S S T S S T S S T S S T S S T S S T S S T S S of Hours
Date Appraised
Pro
p
ert
y
Appraised
Pro
p
ert
y
Client Property
A
pp
raised
of Apprl Report
Claimed
1/1/0000
000 Halsey
Street Newark, NJ Appraisal Bank Multi Family Purchase
7
/ /
/ /
/ /
/ /
/ /
/ /
/ /
SUPERVISOR SIGNATURE:______________________ LICENSE NUMBER:_______________________
SUPERVISOR NAME (PRINT):______________________ Page Total
_
_____
_
EFFECTIVE JANUARY 1, 2008 all experience must be on this log form only.
New Jersey Office of the Attorney General
Division of Consumer Affairs
State Real Estate Appraiser Board
P.O. Box 45032
Newark, New Jersey 07101
(973) 504-6480
CertifiCation and authorization form
f
or a Criminal history BaCkground CheCk
Directions: Answer all of the questions on this form.
1. Name _________________________________________________________ ( ________________________)
LastFirstMiddle MaidenName
2. Address ___________________________________________________________________________________________
Street or P.O. Box City State ZIP code
3. Date of birth __ __ /__ __ /__ __ Sex: Male Female
MonthDayYear 
4. Social Security number _________/ _____ / ________
5. Have you completed the ngerprinting process for any Board or Committee of the New Jersey Division of Consumer
Affairs since November 2003?
Yes No
If “No,” you will receive a separate mailing from the Board or Committee regarding the criminal history background process.
Please send no payment now.
If “Yes,” please provide the following information and follow the instructions outlined below:
_______________________________________________ _______________________________________________
Board or committee requiring the ngerprinting Month and year you were ngerprinted
If you were ngerprinted after November 2003 as part of the criminal history background process for licensure or
certication by any other Board or Committee of the New Jersey Division of Consumer Affairs (a background check
conducted for the Department of Education, another state agency or another state does not apply) you will not be required to
be ngerprinted a second time. However, the Division must perform a criminal history background check each time you apply
for licensure or certication. The fee for this service is $18.75. Payment should be made in the form of a check or money
order payable to the State of New Jersey and should accompany your application packet.
6. Have you ever been arrested and/or convicted of a crime or offense? (Minor trafc offenses such as a parking or speeding
violations need not be listed.)
Yes No
Every such conviction on record must be disclosed. A true copy of every police report, judgment of conviction, sentencing
order and termination of probation order, if applicable, must be submitted with this form. Any documents (including employer
or supervisor letters of reference, if applicable) which present clear and convincing evidence of rehabilitation must be submitted
with this form. Failure to follow these instructions may result in the denial of an initial application.
Note: Copies of judgments, sentencing and termination of probation orders may be obtained from the clerk of the county
where those orders, disposing of the conviction, were issued and led.
Your continuing responsibility to disclose convictions of crimes or offenses: You must notify the Board or Committee
within ve (5) business days if you are convicted of any crimes or offenses after this form has been completed.
Continuation on the reverse side ➨
Mr.
Mrs.
Ms.
BoardorCommittee
________________________
Ofcial Use Only
Resubmit
________________________
Ofcial Use Only
DualLicense
LicenseType1
________________________
Applicant’sNumber
________________________
LicenseType2
________________________
Applicant’sNumber
________________________
CertifiCation
I, ______________________________________________, in making this application to the Board or Committee for
certication or licensure, certify that I am the applicant and that all of the information provided in connection with this
applicationistruetothebestofmyknowledgeandbelief.Iunderstandthatanyomissions,inaccuraciesorfailuretomakefull
disclosuresmaybedeemedsufcienttodenycerticationorlicensureortowithholdrenewaloforsuspendorrevokeacerticate
orlicenseissuedbytheBoardorCommittee.
I voluntarily consent to a thorough investigation of my present and past employment and other activities for the purpose
of verifying my qualications for certication or licensure. I further authorize all institutions, employers, agencies and all
governmental agencies and instrumentalities (local, state, federal or foreign) to release any information, les or records
requestedbytheBoardorCommittee.
Icertifythattheforegoingstatementsmadebymearetrue.Iamawarethatifanyoftheforegoingstatementsmadebymeare
willfullyfalse,Iamsubjecttopunishment.
__________________________________________________________ _________________________________

SignatureofapplicantDate
Rev. 1/2/19
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Trainee Appraiser Permit Application Checklist (State of New Jersey, Dept. of Law & Pub. Safety, Office of the Attorney General)

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Completed 15 August 2020

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