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Broker Application*
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Full Name
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Your answer
Home Address
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Your answer
Home Address (City, State, Zip Code)
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Your answer
Office Name
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Your answer
Company License Number
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Your answer
Broker License Number
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Your answer
Business Address
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Your answer
Business Address (City, State, Zip Code)
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Your answer
Office Phone Number (###)-###-####
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Your answer
Cell Phone Number (###)-###-####
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Your answer
Date of Birth (MM/DD/YYY)
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Your answer
Email Address
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Your answer
Do you specialize in commercial or residential sales?
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Commercial
Residential
Both
Do you hold a real estate license in any other state? Y/N, if yes, where?
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Your answer
Have you worked at a former real estate brokerage? Y/N, if yes, where?
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Your answer
Do you or have you ever belonged to another association? Y/N, if yes provide name of association and NRDS#
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Are there any outstanding complaints against you with the Ohio Real Estate Commission? Y/N, if yes please provide details.
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Your answer
Are there any outstanding complaints against you with any other REALTOR® Associations? Y/N, if yes please provide details.
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