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Corporation License Application RE 201 - California

Corporation License Application Form. This is a California form and can be used in Licensing Bureau Of Real Estate Statewide .
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calBre use only State of California Bureau of real eState Corporation LiCense appLiCation RE 201 (Rev. 6/16) CalBRE RECEivEd datE GEnERal infoRmation This application may be used to license: A corporation with a designated broker-officer, An additional broker-officer with a new or currently A new officer as a substitute (replacement) for the licensed corporation, OR existing designated broker-officer. Read Sections III and IV before completing this application. This application must be completed and signed on lines 30 and 34 by the broker-officer applicant. A Certificate of Status or Articles of Incorporation and the Any changes (addresses, DBA, etc.) to a currently licensed corporation must be submitted on a Corporation Change Application (RE 204A). appropriate fee must accompany this form. Refer to Section IV. sECtion i -- CoRpoRation infoRmation 1A. Does this corporAtion currently holD or hAs it previously helD A reAl estAte license in cAliforniA? calbre use only yes if yes, complete items 1b - 4D. no if no, complete items 2A - 4D 1c. expirAtion DAte 1b. calbre corporAtion license number 2A. corporAtion nAme (print nAme As it AppeArs on certificAte of stAtus, Do not list fictitious business nAmes.) 2b. cAliforniA secretAry of stAte iDentificAtion number (refer to pAge 5) calBre use only 2c. feDerAl tAxpAyer iDentificAtion number (required - see privacy notice) 3A. mAiling ADDress (street ADDress or post office box) 3b. city 3c. stAte 3D. Zip coDe 4A. mAin office ADDress (street ADDress - must be A physicAl ADDress) 4b. city 4c. stAte Ca 4D. Zip coDe 5. fictitious business nAme (if Any) ­ AttAch A copy of the fictitious business nAme stAtement As fileD with the county clerk. sECtion ii -- BRokER-offiCER infoRmation 6A. Do you currently holD or hAve you previously helD A reAl estAte license in cAliforniA? yes if yes, complete items 6b - 11. no if no, complete items 7 - 11 6c. type of license 6D. expirAtion DAte of license 6b. license iDentificAtion number 7. nAme of broker-officer (lAst, first & miDDle) 8. sociAl security number or inDiviDuAl tAxpAyer iD number (required-see privacy notice) 9. birth DAte (mm/DD/yyyy) 10. corporAte officer title 11. type of broker-officer license requesteD: (check one) refer to fee section on pAge 6. DesignAteD broker-officer ADDitionAl broker-officer (refer to Fees.) substitution of current DesignAteD broker-officer (refer to page 5, section ii instructions, #11.) CalBRE usE only restricteD license corporAtion officer cleArAnce rec'D DoJ fbi exAm iD number fingerprints receiveD not neeDeD rAp rec'D DoJ fbi processor # & DAte processeD license effective DAte license expirAtion DAte notes flAg cleArAnce violAtions American LegalNet, Inc. www.FormsWorkFlow.com RE 201 BRokER-offiCER infoRmation (ContinuEd) 12. Do you resiDe in the stAte of cAliforniA? Page 2 of 6 yes no if no, then A consent to service of process (re 234) must Also be completeD. (refer to #12 instruction on page 5.) 14A. hAve you previously serveD in the u.s. militAry? 14b. if yes, were you honorAbly DischArgeD? 13. Are you currently serving in the u.s. militAry? yes no 15. current phone number (required) yes no yes no (see page 6 for expedited processing instructions) 16. current emAil ADDress (required - print clearly) ( ( ) ) 17. business telephone number 18. business cell phone number ( ) 19. hAve you ever useD Any other nAmes (i.e., mAiDen nAme, AkA, etc.)? 20. genDer yes if yes, list nAmes useD: _____________________________________________________ no mAle femAle BaCkGRound infoRmation carefully read and provide detailed answers to questions 21-26. you must provide a "yes" or "no" response to all questions, and completely and accurately provide the detailed information required. Attach additional sheets if you need more space. each additional sheet must be signed by the applicant. failure to disclose pertinent information may result in denial of your license application and/or delays. "convicted" as used in question 21 below includes: · All state, commonwealth, possession, or federal misdemeanor and felony convictions, and all military and foreign convictions. · A verdict of guilty by judge or jury, a plea of guilty, a plea of nolo contendere (or "no contest"), or a forfeiture of bail in the courts. · Convictions expunged under penal Code sections 1203.4, 1203.4a and 1203.41 or equivalent non-California statute must still be disclosed. proof that a conviction has been expunged under penal Code sections 1203.4, 1203.4a and 1203.41 must be submitted with the application. · convictions must be disclosed no matter how long ago they occurred and whether the convicted person was a minor (under 18 years of age, if tried as an adult). Exceptions to "Convicted": do not disClosE · Any Juvenile Court adjudication. · Any conviction sealed under Penal Code section 1203.45 or Welfare and Institutions Code section 781. · Any conviction under Health and Safety Code section 11357(b), (c), (d), or (e), or Health and Safety Code section 11360(b) aftER at least two years have passed since the date of the conviction. 21. hAve you ever been convicteD (sEE paRaGRapH aBovE) of Any violAtion of the lAw At the misDemeAnor or felony level? if yEs, ComplEtE itEm 27 WitH infoRmation on EaCH ConviCtion........................................................................................................................................ 22. Are there criminAl chArges penDing AgAinst you At this time, or Are you currently AwAiting JuDgment AnD sentencing following entry of A pleA or Jury verDict? if yEs, ComplEtE itEm 27........................................................................................................................... 23. hAve you ever hAD A DenieD, suspenDeD, restricteD or revokeD business or professionAl license (incluDing reAl estAte), in cAliforniA or Any other stAte? if yEs, ComplEtE itEm 28............................................................................................................................ 24. Are there Any license DisciplinAry Actions penDing AgAinst A business or professionAl license you holD At this time? if yEs, ComplEtE itEm 28................................. 25. hAve you ever been requireD to register As A sex offenDer pursuAnt to the provisions of section 290 of the cAliforniA penAl coDe or Any compArAble lAw of Any stAte or governmentAl unit? if yEs, ComplEtE itEm 29....................................................... yes yes no no yes yes n
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