(NOTE: PLEASE PRINT ALL ANSWERS IN INK OR USE TYPEWRITER)

ALL QUESTIONS MUST BE ANSWERED FULLY.

FAILURE TO DO SO WILL RESULT IN DELAY AND/OR DENIAL

OF YOUR APPLICATION.

(Mr.) Home

1 Name (Mrs.) __________________________________________ Phone: ________

1. (Miss) (State Full Name)

   1. (a) Are you a citizen of the United States? ______
   2. (b) If naturalized, give Naturalization Certificate No. ______

   3. (c) If you are not a citizen, do you possess a certification of lawful

      permanent residence issued by the U.S. Government? _________________

      Alien Registration Number __________

      7 Have you ever made application for a real estate or time license sharing

      sales license to this Commission or any other Real Estate Commission

      prior to this application?______ Was license granted? ______ If no, give

      reason __________________________________________________________________

      _________________________________________________________________________

      Name of State(s) in which license(s) held and dates held: _______________

      _________________________________________________________________________

      8 Has a Real Estate License or time sharing license held by you ever been

      revoked or suspended? ______ If so, give details and dates:

      _________________________________________________________________________

      _________________________________________________________________________

      9 Which time sharing project do you plan to represent once your license is

      granted?

      _________________________________________________________________________

      10 Give a complete list of all places where you have been engaged in business

      or employed during the past two years and THE FULL INFORMATION REQUESTED

      BELOW. If unemployed for any period, so state:

      Date of Employment

      and Date of Separation

      (If still employed, so

      Name and Address of Name of Supervisor state)

      Employer

      ______________________
      _____________________
      ____________________________

      ______________________
      _____________________
      ____________________________

      ______________________
      _____________________
      ____________________________

      ______________________
      _____________________
      ____________________________

      (In answering item 11 below, you may exclude any information concerning a

      divorce judgement, or any information protected by a juvenile or youthful

      offender act.)

      11 Since your 16th birthday, have you ever been:

   4. (a) Arrested? Yes ___ No ___
   5. (b) Indicted? Yes ___ No ___

   6. (c) Summoned into court as a defendant in a criminal Yes ___ No ___

      proceeding?

   7. (d) Convicted of a criminal offense? Yes ___ No ___
   8. (e) Fined? Yes ___ No ___
   9. (f) Imprisoned? Yes ___ No ___
   10. (g) Placed on probation? Yes ___ No ___

   11. (h) Ordered to deposit bail or collateral for the Yes ___ No ___

       violation of any law police regulation or ordinance

       (excluding minor traffic violations for which a

       fine or forfeiture of $25 or less was imposed)?

   12. (i) A defendant in a civil suit in which a judgment was Yes ___ No ___

       rendered against you?

       NOTE: FAILURE TO ANSWER THIS QUESTION HONESTLY AND COMPLETELY WILL RESULT IN APPLICATION

       BEING DELAYED AND/OR DENIED.

       (IF YES TO ANY OF ABOVE, GIVE COMPLETE EXPLANATION ON ADDITIONAL SHEET AND ATTACH TO APPLICATION.)

       THE RECOMMENDATIONS BELOW MUST BE COMPLETED AND SIGNED BY THREE CITIZENS WHO KNOW THE APPLICANT AND ARE NOT RELATED.

       Are you related to applicant? ______

       How long have you known applicant? __________

       Does applicant bear a good reputation for honesty and trustworthiness? ______

       Do you recommend a license be granted to applicant? ______

       Name ....................(Please type or print name under signature) Occupation: ..............................

       Address: ..............................(Street and Number, City, State & Zip) Phone: ______________________________

       Are you related to applicant? ______

       How long have you known applicant? __________

       Does applicant bear a good reputation for honesty and trustworthiness? ______

       Do you recommend a license be granted to applicant? ______

       Name: ____________________(Please type or print name under signature) Occupation: ______________________________

       Address: ________________________________________(Street and Number, City, State & Zip) Phone: ______________________________

       Are you related to applicant? ______

       How long have you known applicant? __________

       Does applicant bear a good reputation for honesty and trustworthiness? ______

       Do you recommend a license be granted to applicant? ______

       Name: ____________________(Please type or print name under signature) Occupation: ______________________________

       Address: ______________________________(Street and Number, City, State & Zip) Phone: ______________________________

       
       AFFIDAVIT
       

       STATE OF ALABAMA

       CITY OF ..........

       COUNTY OF ....................

       ____________________(Name of Applicant) being duly sworn, deposes and says he/she is the applicant above named, and has read the herein application and the answers thereon noted, that such answers are true to his/her knowledge except as to any matter therein stated to be alleged upon information and belief and that as to such matter he/she believes it to be true, and that he/she has personally attached signature to this affidavit.

       As an applicant for licensure by the

       Alabama Real Estate Commission. I

       hereby give my permission for the

       staff of the Commission to have

       access to such educational,

       employment, law enforcement and other

       records as are necessary to verify or

       contradict the information which I

       have provided herein.

       Sworn to and subscribed before me this (Signed) ______________________________

       the ______ day of __________, 19___ (Signature of Applicant)

       ______________________________________ (This signature must be identical with

       NOTARY PUBLIC name as shown under No. 1 on front

       page of application.)

   2 Residence Address: ______________________________ City: _____ Zip: _____

   (Street & No. or Rural Route)

   3 Mailing Address: ________________________________________________________

   4 Presently Employed By: ____________________________ Phone: _____________

   5 Date of Birth: ______________________ Race: _________ Sex: __________

   Mo Day Year

   (Each applicant must be at least 19 years of age)

   6 Are you a bona fide resident of Alabama? ____ Length of Residence: _____

   (SUBMIT PROOF OF SUCH RESIDENCY.)