Non-Resident Appraisal Application for temporary practice

June 2019

NON-RESIDENT APPRAISER APPLICATION

FOR TEMPORARY PRACTICE

(FOR OFFICE USE ONLY)

Temporary Practice Fee: _______________________ Date of Application: ________________

Certification/Licensed Held: ____________________ Date Permit Issued: _________________

ASC Reviewed _______________________________ Permit Number: ____________________

The state of KENTUCKY will recognize temporarily the certificate or license of a real estate appraiser in good

standing issued by another state if the appraiser’s business is of a temporary nature, the appraiser registers with the

state appraiser regulatory board or agency of the temporary practice state before beginning the assignment, and pays

the required temporary practice fee. The temporary practice permit is only valid for a single assignment within the

temporary practice state. A single appraisal assignment may include one or more properties under one contract for a

single client.

THE TEMPORARY PRACTICE PERMIT IS FOR:

( ) State Licensed Appraiser ( ) State Certified Residential Appraiser ( ) State Certified General Appraiser

INSTRUCTIONS: Please type or print legible in ink the following information and:

 Complete and submit this application and the attached Affidavit and Consent to Service of Process forms

(notarized) to the Kentucky Real Estate Appraisers Board

 Include the appropriate fee of $150.00; and

 Complete any supplementary requirements of the state issuing the temporary practice permit.

NAME: ______________________________________________________________________________________

Last First MI

RESIDENCE ADDRESS: _______________________________________________________________________

Street

_____________________________________________________________________________________________

City State Zip Code

BUSINESS NAME: ____________________________________________________________________________

BUSINESS ADDRESS: _________________________________________________________________________

Street

_____________________________________________________________________________________________

City State Zip Code

TELEPHONE NO’s: _______________________ _______________________ ________________________

Business Home Email

FAX NUMBER: _____________________________ DATE OF BIRTH: ________________________________

RESIDENT STATE: ________________ RESIDENT STATE APPRAISER LICENSE NUMBER: ____________

Kentucky Real Estate Appraisers Board

321 N. Madison Avenue

Richmond, KY 40475

Phone: 859-623-1658 Fax: 859-623-2598

Website: www.kreab.ky.gov

June 2019

If you answer “yes” to any of the following questions, you must submit a written explanation and official

documentation as attachments to your application:

1. Have you ever entered a plea of nolo contendere, or been found guilty of, or been “convicted” of a

misdemeanor or felony (do not include minor traffic violations)?

Yes ________ No _________

2. Have you or any partnership or corporation in which you were a legal or financial participant ever been

disciplined, sanctioned, or fined AND/OR had a license, certificate or registration suspended, revoked,

surrendered or resigned by the board or agency issuing the license, certificate, or registration?

Yes ________ No __________

3. Have you ever had an application for a real estate appraiser license or certification or an application for a non-

resident temporary practice registration or permit been denied?

Yes ________ No __________

THE APPRAISAL ASSIGNMENT: If the assignment includes more than one property, a letter of engagement

must be attached to the temporary permit application. If there are multiply letters of engagement, this will be

considered multiple assignments and a separate fee is required for each assignment.

Name of client: ____________________________________________________________________________

Contact Person: ____________________________________________________________________________

Specific Property Address(es) to be appraised (including city, county and state): ________________________

__________________________________________________________________________________________

Type of property being appraised (i.e. Industrial Bldg., Farmland, etc.): ________________________________

__________________________________________________________________________________________

Estimated time to complete the assignment: ______________________________________________________

June 2019

AFFIDAVIT OF APPLICANT

I hereby state that I have fully read and understand the questions presented in this application and have answered

them truthfully and completely. I affirm that I have read and agree to comply with all provisions of the state of

KENTUCKY laws and rules governing real estate appraiser licensing and certification. I acknowledge that my

failure to make a full and accurate disclosure of any information requested herein may result in the denial of, and/or

revocation of, my application for temporary practice.

I agree to provide additional information or documentation that may be deemed necessary by the state issuing the

temporary practice permit to verify information I have disclosed in the application.

I also hereby authorize any agency of federal, state, or local government, consumer report agency, present or former

employer, or any other individual, partnership, corporation, or association, in this or any other state, or its

representatives to furnish to the state issuing the temporary practice permit, any information bearing upon my

background for honesty, trustworthiness, integrity, and competence to transact business as a real estate appraiser in

such manner as to safeguard the interest of the public. Such information may include, but is not limited to, records

of any convictions for misdemeanors and/or felonies, the circumstances involved in any such convictions, and the

suspension, revocation, or surrender of any license authorizing me to engage in any profession or occupation.

I acknowledge that I understand that the temporary practice permit obtained hereby is not valid for any individual

other them myself.

I acknowledge that I understand that the state issuing my temporary practice permit may have requirements for

temporary practice in addition to this application and that it is my responsibility to comply with the requirements in

that state.

I hereby agree to develop my appraisal and issue my appraisal report in conformance with the edition of the Uniform

Standards of Professional Appraisal Practice (USPAP) in effect at the time that the appraisal report is issued.

I hereby swear (or affirm) that I am in good standing in all states that I currently hold an real estate appraiser license

or certification, that the foregoing statements are true and correct to the best of my knowledge and belief, and that I

have not suppressed or excluded any information that may have a bearing on this application.

I understand that I am not allowed to practice real estate appraisal activity in the temporary practice state

until my application is approved and I am issued a Temporary Practice Number.

Must be signed in the presence of a Notary Public.

_________________________________________ _________________________________

Signature of Applicant Date of Signature

STATE OF _____________________

On this _________ day of _______________, in the year ___________, before me __________________________,

Personally appeared ___________________________________________________________ and proved to me on

the basis of satisfactory evidence to be the person whose name is subscribed to this instrument, and acknowledged

that he or she executed it.

SEAL _________________________________________________

Signature of Notary Public

My Commission Expires: ____________________________

June 2019

CONSENT TO SERVICE OF PROCESS FORM

KNOW ALL MEN BY THESE PRESENTS:

I, ________________________________________ am a non-resident of the state of KENTUCKY, and I am an

applicant before the KENTUCKY REAL ESTATE APPRAISERS BOARD of the state of KENTUCKY for a

real estate appraiser temporary practice permit.

I agree that my acceptance of a temporary practice permit issued by the KENTUCKY REAL ESTATE

APPRAISERS BOARD is equivalent to an appointment by me of the administrator, director or designee of the

board or agency as my agent for service of in lawful summons, process or pleading in any action or suit against me

in any Court in the state issued the temporary practice permit arising out of my activities as a certified or licensed

appraiser. I further agree that service so made upon the administrator, director or designee of the board or agency

shall have the same legal force and validity as if service had been made on me personally in this state provided that:

1. Notice of the service and a copy of the summons, process or pleading is sent by registered mail by the

plaintiff or the plaintiff’s attorney to the defendant, at the most recent address furnished to the board or

agency by the non-resident licensee or to the non-resident licensee’s last-known address; and

2. An affidavit of the plaintiff or the plaintiff’s attorney of the mailing is appended to the summons,

process or pleading and entered as a part of the return thereof.

I, __________________________________________ do hereby certify that records of my real estate appraisal

activity conducted in the state issuing the temporary practice permit will be kept at the following address:

____________________________________________________________________, and that they will be available

to the board or agency administrator, director or designee during normal business hours.

In witness whereof, applicant or license or certificate holder has subscribed his or her name hereto this _______ day

of ____________________, 20 _____.

________________________________________________

Applicant’s Signature

STATE OF ___________________

One this ________ day of _____________________, in the year __________________, before me,

___________________________, personally appeared and proved to me on the basis of satisfactory evidence to be

the person whose name is subscribed to this instrument, and acknowledged that he or she executed it.

SEAL ________________________________________________

Signature of Notary Public

My Commission Expires: ___________________________