Real Estate Appraiser License South Carolina

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                                   REAL ESTATE APPRAISERS BOARD
                                 110 CENTERVIEW DRIVE, COLUMBIA SC 29210
                                  P. O. BOX 11847, COLUMBIA SC 29211-1847
                                     (803) 896-4400   FAX (803) 896-4404
                                                     Doc # 205


NAME OF APPLICANT___________________________________________________________________________


1.   Complete Section I below and Section II on the reverse side. If you are a nonresident, please contact the South
     Carolina Real Estate Appraisers Board to obtain a "Consent to Jurisdiction" form that must be completed by all
     nonresidents and submitted with this application. CAUTION: Incomplete or incorrect applications will be

2.   Attach a NON-REFUNDABLE fee of $390 ($415 if applying April 1, 2008 – June 30, 2008) (certified check,
     cashier's check or money order--personal checks or company checks are NOT ACCEPTED) payable to LLR.

3.   If you are a resident appraiser applying to upgrade your license do not complete this application.                  The
     Reclassification Application (Document #285) needs to be completed.

Since you are not officially a Licensed Real Estate Appraiser until the Board approves your application, you must not
engage in or conduct or advertise or hold yourself out as engaging in or conducting the business of or act in the capacity
of a State Licensed Real Estate Appraiser in South Carolina until you receive your wall certificate and pocket cards.

_____Yes     _____No      1. Have you ever been registered, permitted, licensed, or certified in another state as an
                          appraiser? If your answer to this question is YES, list the state(s) below, obtain from each
                          state's regulatory authority a certification of your history, not more than 90 days old, and
                          attach it to this application. ______________________________________________________

       Yes         No     2. PLEASE CHECK ONE:                      High School Graduate                GED

_____Yes     _____No      3. Have you ever held or do you currently hold a South Carolina appraiser registration,
                          permit, license, or certification? If yes, give your registration, permit, license, or
                          certification number. _______________________________________________________
                             If yes, but under a different name, what name?________________________________

_____Yes     _____No     4. Have you ever been convicted in a court of this or any other state, district, territory of the
                             United States, or foreign country of forgery, embezzlement, obtaining money under false
                         pretenses, theft, extortion, or conspiracy to defraud or other like offense or been convicted
                         of a felony or a crime involving moral turpitude or pled nolo contendere to any such
                 offense? If yes, attach a complete explanation.

_____Yes     _____No      5. Have you ever been denied an appraiser registration, permit, license, or certification or had
                              an appraiser registration, permit, license, or certification or professional license of any type
                              suspended, revoked, or surrendered in South Carolina or elsewhere; or are there currently
                              any charges pending against you in connection with any appraiser or other professional
                          license that you hold? If yes, attach a copy of the regulatory agency's Order, if applicable,
                          and a complete explanation.
_____Yes      _____No     6. Are there any unpaid court judgements, bankruptcy, or liens against you, or are you
                          involved in any litigation? If yes, explain on a separate sheet.


1.      Legal Name __________________________________________________________________________________
                          Last                                                First                                    Middle

2.      Date of Birth     ______/______/______
                           Month           Day      Year

3.      Sex________________                     Race________________________

4.      Residence Address______________________________________________________________________________
                                 Street/Route                                                             County

        ________________________________________________________________                    (_____) _____________________
           City                                            State                 Zip Code           Residence Phone

5.      Business Name__________________________________________________                     (_____) ____________________
                                                                                                     Business Phone

6.      Business Address______________________________________________________________________________
                                                           Street                                               City

                          City                                                State                 Zip Code

7.      Preferred Mailing Address_______________________________________________________________________
         (Required)                                        Street or PO Box

                          City                                                State                 Zip Code

8.      Current E-mail Address

9.      I am a South Carolina:            _____ Resident            _____ Nonresident


The undersigned, in making this application to the South Carolina Real Estate Appraisers Board for a real estate
appraiser under the provisions of Chapter 60 of Title 40 of the Code of Laws of South Carolina, swears (or affirms) that
he or she is the applicant named herein and that the answers and information provided are true to the best of his or her
knowledge and belief. Further, the applicant understands that any omissions, inaccuracies or failure to fully disclose can
be deemed sufficient grounds to: 1) deny applicant's licensure; 2) withhold renewal of applicant's license; 3) suspend or
revoke the applicant's license; 4) take any other disciplinary action against applicant which is authorized by law. The
applicant hereby authorizes any and all law enforcement departments, agencies and officials thereof to release to the
South Carolina Real Estate Appraisers Board any and all criminal history information, and further releases said
departments, agencies and officials from all liability.

The undesigned further certifies that he or she had read and is familiar with the South Carolina Real Estate Appraiser
Registration, License, and Certification Act and any Regulations promulgated by the South Carolina Real Estate
Appraisers Board, and in the event he or she becomes licensed, agrees to obey said Laws and Regulations.


Date ________________      Signature of Applicant __________________________________________________________

STATE OF ______________________________________________                       County of _________________________________

Subscribed and sworn to before me this ____________ day of __________________________________ 20 ___________

Notary Public for the State of ____________________________________________________________________________
Signature of Notary Public__________________________________________ My Commission Expires: _______________
The South Carolina Real Estate Appraisers Board is An Affirmative Action Equal Opportunity Employer
South Carolina Department of Labor, Licensing and Regulation
PO Box 11847
Columbia, SC 29211
                                    AFFIDAVIT OF ELIGIBILITY

Pursuant to Section 8-29-10 SC Code of Law, ALL applicants for a South Carolina license after July 1, 2008 are
required to complete and sign this Affidavit of Eligibility.

Section A: LAWFUL PRESENCE in the United States.

I, (please print your full name) _____________________________________________, swear or affirm under
penalty of perjury under the laws of the State of South Carolina that (check 1, 2 or 3 below):

1. ___ I am a United States citizen or legal permanent resident eighteen years of age or older; or

2. ___ I am not a US citizen but am lawfully present in the US as evidenced by one of the following
             a. ___ I am a qualified alien as defined in 8 U.S.C. sec 1641, eighteen years of age or older.
             b. ___ I am a nonimmigrant under the “Immigration and Nationality Act,”
                     Federal Public Law 82-414 as amended, eighteen years of age or older.

3. ___ I am not physically present in the US under 8 U.S.C. sec 1621 (c) (2) (c) or employed in the US
       pursuant to 8 U.S.C. 1621 (c) (2) (a) (check either a or b below):
             a. ___ I am a US citizen, not physically present or employed in the United States.
             b. ___ I am a Foreign National, not physically present or employed in the United States.

 If you selected either 3.a. or 3.b., you do not need to complete Section B. Skip to Section C.

Section B: Secure and Verifiable Document. This section must be completed if you checked number 1 or 2 in
Section A.

1. Please check one of the following acceptable secure and verifiable documents. Complete documentation must be
provided upon request only.

                 Any South Carolina Driver License, South Carolina Driver Permit or South Carolina Identification Card,
                  expired less than one year.
                 Out-of-state issued photo Driver's License or photo identification card, photo driver’s permit expired less
                  than one year. State: _______________

                 Valid Temporary Resident Card
                 Certificate of Naturalization with intact photo

                 Certificate of (US) Citizenship with intact photo

                 Other: (Name of verifiable document) ___________________________________________________

   2. Enter the state or the federal agency name where this secure and verifiable document was issued.

      (If issued by a state agency, include both the state and agency name.)

    3. What is the secure and verifiable document number? ____________________________________________

                                                                                                   Social Security Number

       4. What is the expiration date of your secure and verifiable document?        /    /         (month/day/year)

         (If you hold a document without an expiration date, such as a military ID or naturalization certificate, write

Section C: Attestation.

•      I understand that this sworn statement is required by law because I have applied for or hold a professional or
       commercial license regulated by 8 U.S.C. sec. 1621. I understand that state law requires me to provide proof that
       I am lawfully present in the United States. I may also be required to provide proof of lawful presence.
•      I understand that in accordance with section 8-29-10 false statements made herein are punishable by law. I state
       under penalty of perjury that the above statements are true and correct.
•      I am the person identified above and the information contained herein is true and correct to the best of my
       knowledge. I understand that under South Carolina law, providing false information is grounds for denial,
       suspension or revocation of a license, certificate, registration or permit.
•      I understand that the above information must be disclosed to the Department of Labor, Licensing and Regulation
       upon request and is subject to verification.

____________________________________________                                     ________________________________
Signature                                                                        Date

Please print your name as shown on your secure and verifiable document.

Professional License Type: ____________________________________

License Number (if already licensed): ____________________________

The South Carolina Code of Laws requires that every individual who applies for an occupational or professional license
provide a social security or alien identification number for use in the establishment, enforcement and collection of child
support obligations and for reporting to certain databanks established by law. Failure to provide your social security
number for these mandatory purposes will result in the denial of your licensure application. Social security numbers
may also be disclosed to other governmental regulatory agencies and for identification purposes to testing providers
and organizations involved in professional regulation. Your social security number will not be released for any other
purpose not provided for by law.

9/08                               Affidavit of Eligibility - Page 2 of 2

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