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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 .
 Fillable pdf Last Modified 11/20/2014
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CalBre use Only State of California Bureau of real eState Corporation LiCense appLiCation RE 201 (Rev. 9/14) 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 34 and 38 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). calbre use only 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? 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) 2c. feDerAl tAxpAyer iDentificAtion number (requireD-see privAcy notice) 3A. mAiling ADDress (street ADDress or post office box) 3b. city 3c. stAte CalBre use Only 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 6D. expirAtion DAte of license 6b. license iDentificAtion number 6c. type of license 7. nAme of broker-officer (lAst, first & miDDle) 8. sociAl security 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 yes ( ( ) ) no no if no, then A consent to service of process (re 234) must Also be completeD. (refer to #12 instruction on page 5.) 14. hAve you previously serveD in the militAry? 13. Are you currently serving in the militAry? yes ( ) no 15. business telephone number (Do not list fAx numbers.) - requireD 16. resiDence telephone number - requireD 17. cell phone number - requireD 18. emAil ADDress 19. hAve you ever useD Any other nAmes (i.e., mAiDen nAme, AkA, etc.)? yes 20. height if yes, list nAmes useD: _____________________________________________________ 21. weight 22. color of eyes no 24. genDer 23. color of hAir mAle femAle BaCkGRound infoRmation carefully read and provide detailed answers to questions 25-30. 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 25 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 section 1203.4 or equivalent non-California statute must still be disclosed. · 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. 25. hAve you ever been convicteD (sEE paRaGRapH aBovE) of Any violAtion of the lAw At the misDemeAnor or felony level? if yEs, ComplEtE itEm 31 WitH infoRmation on EaCH ConviCtion........................................................................................................................................ 26. 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 31........................................................................................................................... 27. 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 32............................................................................................................................ 28. Are there Any license DisciplinAry Actions penDing AgAinst A business or professionAl license you holD At this time? if yEs, ComplEtE itEm 32................................. 29. 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 33....................................................... yes yes no no yes yes no no yes no 30. hAve you ever been orDereD to ceAse, Desist AnD/or refrAin from Doing An Act(s), or from violAting A lAw, rule or regulAtion by, or citeD for A breAch of ethics or unprofessionAl conDuct, by An ADministrAtive Agency or pr
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