Ohio > Statewide > Department Of Commerce > Real Estate > Broker
Voluntary Hold Reactivation Application - Ohio
| Voluntary Hold Reactivation Application Form. This is a Ohio form and can be used in Broker Real Estate Department Of Commerce Statewide . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
Please visit our website at www.com.ohio.gov/real 614 | 466-4100 Fax 614 | 644-0584 TTY/TDD: 800 | 750-0750 REAL ESTATE VOLUNTARY HOLD REACTIVATION APPLICATION FOR DIVISION USE ONLY FILE NUMBER You may type your responses directly onto the form and then print. Use this form to reactivate a license to active or inactive status from a voluntary hold status within 12 months of requesting the voluntary hold status to avoid going into a resigned status. A resigned status is a permanent status. Once a license is resigned, it cannot be reactivated. A new license must be obtained in accordance with the requirements specified in Ohio Revised Code 4735.07 or 4735.09, as applicable. Submit appropriate renewal fee and reactivation fee (see fee schedule on page 2); enter continuing education courses on the Continuing Education Compliance form and enclose copies of the attendance certificates for each continuing education course taken, if applicable. APPLICANT INFORMATION FIRST NAME HOME ADDRESS CITY STATE ZIP CODE HOME PHONE MIDDLE NAME LAST NAME PLEASE NOTE: THIS FORM IS TO BE USED TO REACTIVATE FROM VOLUNTARY HOLD STATUS ONLY WITHIN TWELVE (12) MONTHS OF PLACING A LICENSE INTO VOLUNTARY HOLD STATUS. INACTIVE OR SUSPENDED LICENSEES SHOULD USE THE APPROPRIATE TRANSFER/REACTIVATION FORM TO REACTIVATE A LICENSE. SUFFIX (JR., SR.) LICENSE TYPE(S) HELD: ( FILE NUMBER MAIN BUSINESS ADDRESS CITY ) BROKER FILE # ________________ SALESPERSON FILE # ________________ PROSPECTIVE BROKER INFORMATION Complete if applicant is reactivating to an active status. OFFICIAL CORPORATION, L.L.C., PARTNERSHIP OR ASSOCIATION NAME DOING BUSINESS AS (D.B.A.) NAME STATE ZIP CODE BUSINESS PHONE ( REASON FOR COMPLETING THIS FORM ) REACTIVATE LICENSE TO ACTIVE STATUS FROM VOLUNTARY HOLD STATUS Include completed Continuing Education Compliance Form and copies of attendance certificates, if applicable; and appropriate fee see fee schedule on page 2. REACTIVATE LICENSE TO INACTIVE STATUS FROM VOLUNTARY HOLD STATUS Include completed Continuing Education Compliance Form and copies of attendance certificates, if applicable; and appropriate fee see fee schedule on page 2. LICENSEES PLEASE NOTE: A Salesperson reactivating to Active status must obtain a broker's signature for the certification on Page 2. A Broker reactivating to Active status must sign the Applicant Certification. A Licensee whose triennial renewal/continuing education deadline passed while the license was in Voluntary Hold status must remit with this application: the appropriate renewal fee and reactivation fee (see fee schedule on page 2), a Continuing Education Compliance Form and copies of continuing education attendance certificates. A Licensee's whose 10-hour post licensure education deadline passed while the license was in Voluntary Hold status must remit with this application: the 10-Hour Post Licensure Education Form and a copy of the course attendance certificate. A Broker reactivating with an existing company must submit the prospective company's original license with broker addendum along with this application. NOTICE: Refusal of check payment by the drawer's bank may result in a $100 fee to the Superintendent or refusal or withdrawal of approval of this application. NOTICE: This application and the information contained therein, except for the social security number, is public record pursuant to Ohio Revised Code 149.43. COM (Rev. 02/2010) "An Equal Opportunity Employer and Service Provider" Page 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Licensees reactivating from Voluntary Hold status should remit the following fees: License Type: BROKER Renewal Fee* (if applicable): Reactivation Fee: Total due: $147.00 $25.00 $172 $117.00 $25.00 SALESPERSON $142 *A Licensee whose triennial renewal deadline passed while the license was in voluntary hold status should remit the appropriate renewal fee along with the reactivation fee. ETHICAL CONDUCT AND LEGAL HISTORY PLEASE ATTACH A COMPLETE EXPLANATION FOR ANY QUESTIONS ANSWERED "YES." QUESTIONS CONCERNING PROFESSIONAL LICENSES APPLY TO ALL PROFESSIONAL LICENSES REGARDLESS OF PROFESSION. SINCE your most recent filing of an application for Ohio real estate licensure, renewal or transfer/reactivation application, have you: YES YES YES YES YES YES NO been disciplined in any manner by any public entity or professional or trade association for any violation of any professional licensing law, regulation or ethical rule? NO been refused or denied any professional license or registration by any public entity? NO had any professional license revoked, suspended or limited in any way for any reason? NO been notified by any public entity or professional or trade association that you were under investigation for any violation of any professional licensing law, regulation or ethical rule? NO been the subject of any unsatisfied judgments? NO been convicted of, plead guilty to or been granted intervention in lieu of conviction for any unlawful conduct excluding minor traffic violations? LIST:____________________________________________________ APPLICANT CERTIFICATION THE APPLICANT MUST COMPLETE THE FOLLOWING CERTIFICATION. I certify that all of the statements on this application and all of the attached materials are complete and accurate. I understand that any false statement on this form may subject me to criminal prosecution and the loss of my Ohio real estate license. ___________________________________ _______________ SIGNATURE OF APPLICANT DATE BROKER CERTIFICATION A SALESPERSON REACTIVATING TO ACTIVE STATUS MUST HAVE THE SPONSORING BROKER COMPLETE THE FOLLOWING CERTIFICATION. I hereby certify that, from the investigations made by me, I find the above listed applicant for a real estate license is honest, truthful and of good reputation. I understand that any false statement on this form that is known to me at the time of my signing may subject me to criminal prosecution and the loss of my Ohio real estate license. ___________________________________ _______________ NAME OF BROKER (please type or print) FILE NUMBER ___________________________________ _______________ SIGNATURE OF BROKER DATE Page 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com REAL ESTATE CONTINUING EDUCATION COMPLIANCE FORM Proof of Continuing Education Compliance may not be submitted earlier than 60 days before the due date. Each licensee shall submit proof to the superintendent that the licensee has satisfactorily completed thi
|
|||||||
