Real Estate License Application Form - Wa Department Of Licensing Page 2
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1
2Employing firm information
(please type or print)
TYPE or PRINT Firm name (where applicant will be licensed)
Firm license number
Mailing address
(Area code) Telephone number
City
State
ZIP code
Physical address (if different)
City
State
ZIP code
TYPE or PRINT Designated broker name as it appears on your license
License number
TYPE or PRINT Branch manager name as it appears on your license
License number
Answer the following
Do you understand that we, the Department of Licensing (DOL), have the right to enter your
business location(s) at reasonable times to inspect the records that you are required to keep
by the laws and regulations that govern the license you are applying for? . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
Do you agree to cooperate with an audit or an investigation by providing DOL with the requested
documents and a written explanation of the matter contained in a complaint? . . . . . . . . . . . . . . . . . . . . . .
Yes
No
Certification
I certify under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct.
X
_______________________________________________________________________
___________________________________________________
Date and place
Designated broker/ Branch manager signature
When can I begin working?
You may begin working from the postmark or hand delivery date of your application to the Real Estate Licensing office,
provided the application is complete.
Do I need a fingerprint card?
You need a fingerprint card if this application is for your first active broker or managing broker license. If you need to
submit a Real Estate Program fingerprint card you are required to do so before we will process your application.
How and where do I get my fingerprints taken?
You may take your Real Estate Program fingerprint card to any Washington State Patrol approved fingerprinting service.
Each fingerprinting service sets its own fee, which you must pay at the time of fingerprinting. This is in addition to the
$35.25 processing fee you submit with this application.
Name change
Complete with this form and enclose a brief letter stating what your name is being changed to and from.
Transfer
Complete this form and return your current license showing the office you are leaving.
Once filed, this application is a public record and is subject to public disclosure.
For office use only
Prof
License number
Effective date
Expiration date
Firm number
RCW 18.85.191; 18.85.361(6); 26.23.150; 42.56.
The Department of Licensing has a policy of providing equal access to its services.
If you need special accommodation, please call (360) 664-6500 or TTY (360) 664-0116.
RE-620-004 (R/7/10)W Page 2 of 2
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