Vermont Secretary of State Office of Professional Regulation Real Estate Appraiser Board 89 Main Street 3 rd Floor Montpelier VT 05620-3402 Vermont Real Estate Appraiser Application by Examination Judith Griffen Licensing Board Specialist (802) 828-3228 jgriffen@sec.state.vt.us www.vtprofessionals.org Application for Real Estate Appraiser - Fee 275.00 (includes ASC fees) This is an: Initial Application Upgrade of an existing license Applying for: Certified Residential Certified General (Use Ink or Typewritten only) First Name (Legal name no nicknames) MI Last Name & Title (Jr., Sr., II, III, etc.) Previous Name(s) (Maiden) Social Security Number: / / ** (Providing your social security number (SSN) is mandatory, and requested under the authority granted by 42 U.S.C. 405(c)(2)(C). It will be used by the Departments of Taxes, Child Support, and the Department of Labor in the administration of Vermont law, to identify individuals affected by such laws. Your SSN is not disclosed as part of a public records request); OR Passport Number: *** (If you do not have a social security number you must provide a passport number as evidence that there is no attempt to procure a license fraudulently (3 V.S.A. 129a) P.O. Box Mailing Address: Street/Apt # (911 Address if Different) City/State/Zip Country Phone: ( ) - Cell Phone: ( ) - Fax: ( ) - E-Mail: Date of Birth Gender: (Circle One) Female Male List below every state in which you now hold, or have ever held, a license to practice State License # Date Issued Date Expired
Section B: Vermont Mandatory Good Standing Declarations CHILD SUPPORT: Child Support Orders, 15 V.S.A. 795(b): Good standing for child support is defined by 15 V.S.A. 795(d). You must check the appropriate box. As of the date of this application: I am not subject to a child support order. I am subject to a child support order and I am in good standing or in full compliance with a plan to pay any and all child support. I am subject to a child support order and I am NOT in good standing or in full compliance with a plan to pay any and all child support. Please contact the Office of Child Support at (802) 241-2319. OCS must report your compliance to this office before you may be issued a license. TAXES: Taxes Due to the State of Vermont, 32 V.S.A. 3113(b): Good Standing for taxes due is defined by 32 V.S.A. 3113(g). You must check the appropriate box. As of the date of this application: I am in good standing with respect to, or in full compliance with a plan to pay any and all taxes due to the Vermont Department of Taxes. I am NOT in good standing * with respect to or in full compliance with a plan to pay any and all taxes due to the Vermont Department of Taxes. Please contact the Vermont Department of Taxes at (802) 828-2515 for more information. The Tax Department must report your compliance to this office before you may be issued a license. DISTRICT COURT FINES/JUDICIAL BUREAU: Court judgments for fines or penalties, 4 V.S.A. 1110(b): Good standing for court judgments is defined by 4 V.S.A. 1110(c). You must check the appropriate box. As of the date of this application: I have no unpaid judgments issued by the judicial bureau or criminal division of the superior court for fines or penalties for a violation or criminal offense. I am in good standing with respect to any unpaid judgment issued by the judicial bureau or criminal division of the superior court for fines or penalties for a violation or criminal offense. I am NOT in good standing with respect to any unpaid judgment issued by the judicial bureau or criminal division of the superior court for fines or penalties for a violation or criminal offense. You must provide this office documentation of compliance before you may be issued a license. RESTITUTION ORDERS: Unpaid Judgments, 13 V.S.A. 7043a: Good standing for restitution orders is defined by 13 V.S.A. 7043a(c). You must check the appropriate box. As of the date of this application: I have no restitution order. I am in good standing with respect to any restitution order. I am NOT in good standing with respect to any restitution order. You must provide this office documentation of compliance before you may be issued a license.
Section C: Vermont Mandatory Credential and Fitness Questions Circle or for each of these questions. If the answer is, follow the instructions provided. Has Vermont or any other state, federal authority, or other jurisdiction (US or elsewhere) denied an application by you for a license, certificate, or registration to practice a profession or occupation? If, you must attach a copy of the order or official notification of the action(s). Has Vermont or any other state, federal authority, or other jurisdiction (US or elsewhere) taken any disciplinary action (restricted, suspended, revocation or conditioned) against a license, certificate, or registration that you hold or held in any profession or occupation? If, you must provide a copy of the order or official notification of the action. Have you ever surrendered a license, certificate or registration to a licensing authority in Vermont or any other state, federal authority or other jurisdiction (US or elsewhere)? If, you must provide a detailed written explanation and copies of any applicable documentation. Are you currently under investigation by a licensing authority in Vermont or any other state, federal authority or other jurisdiction (US or elsewhere)? If, you must provide a detailed written explanation and a copy of any available information from the licensing authority. Have you EVER been convicted of a crime other than a minor traffic violation? (Driving While Intoxicated and Driving Under the Influence are not minor traffic violations. ) If, you must provide a detailed written explanation and attach the official court documents (i.e., affidavit of probable cause, the information and/or the docket report.) Do you have any criminal charges pending against you in any jurisdiction (US or elsewhere)? If, you must provide a detailed written explanation and attach a copy of the charging documents. te: Vermont law requires that you report to the Office of Professional Regulation a felony conviction or any conviction of a crime related to the practice of your profession within 30 days. 3 V.S.A. 129a(a)(11). The answers to the following questions are not subject to public disclosure: Do you have a physical or mental condition or disorder which in any way impairs or limits your ability to practice this profession with reasonable skill and safety? If, you must have your health care provider submit a detailed statement explaining how you are able to practice safely. Does your use of alcohol, substances, or prescription medications impair or limit your ability to practice this profession with reasonable skill and safety? If, you must provide a detailed written explanation. Are you currently addicted to or in any way dependent on alcohol or habit forming drugs? If, you must provide a detailed written explanation.
Statement of Applicant I certify, under the pains and penalties of perjury, that all information I have provided in this application is true and accurate. I understand that furnishing false information may constitute unprofessional conduct and result in the denial of my application or further disciplinary action. The maximum penalty for perjury is fifteen years in prison and/or a $10,000 fine. (13 V.S.A. 2901) Signature of Applicant Date
VERMONT BOARD OF REAL ESTATE APPRAISER EXPERIENCE NARRATIVE SUMMARY Applicant s Name: Experience for calendar year Experience earned during calendar year YOU MUST COMPLETE A SEPARATE PAGE FOR EACH CALENDAR YEAR OF EXPERIENCE CLAIMED. Total # of Appraisal Assigned Category of Appraisals Sole Appraisal Supervised Appraisal Single-Family (complete appraisal) Single-Family (limited appraisal) Multi-Family (two-four units) Residential Lots (4 lots or less) Rural Residential/Land (50 acres or less) Rural Agricultural (50 to 250 acres) Residential Multi-Family (5-12 units) Apartments, condos, townhouses, mobile home parks, etc.) Residential Multi-Family (13 units or more) Commercial Single-Tenant (office building, retail store, restaurant, service station, bank, daycare center, etc.) Commercial Multi-Tenant Vacant Land (Undeveloped nonresidential tracts, residential multi-family sites, commercial sites, industrial sites, lands in transition, etc.) Industrial (Warehouse, manufacturing plant, etc.) Institutional (Nursing home, hospital, school, church, government building, etc.) Appraisal Review Ad Valorem* Sole Appraisal means that you prepared and signed the appraisal ALONE. Supervised Appraisal means that you provided significant real property appraisal assistance. *Ad Valorem credit will be awarded to applicants who demonstrate that they a. used techniques to value property similar to those used by appraisers and effectively used the appraisal process. Credit for experience in mass appraisals will be awarded for highest and best use analysis, model specifications (developing the model), and model calibration (developing adjustments to the model). Other components of the mass appraisal process, by themselves, will not be awarded credit. credit is given for data gathering.
Appraisal Log An appraisal log shall be maintained by the Appraiser Trainee and the supervising appraiser jointly. All applications must be submitted with an appraisal log. Information needed on the appraisal log are listed below and must be signed off by both Trainee and the trainee s supervisor. 1. Type of property; 2. Date of report; 3. Address of appraised property; 4. Description of work performed by the trainee and scope of the review and supervision of the supervising appraiser; 5. Number of actual work hours by the trainee on the assignment; and 6. The signature and state certification number of the supervising appraiser must be on each and every page of your log. Separate appraisal logs shall be maintained for each supervising appraiser if applicable. If the appraisal log is not submitted or does not have all of the above information on it, your application will be considered incomplete.
STATEMENT OF APPRAISER I hereby certify that I have completed the appraisal experience in accordance with the laws and rules of the Board of Real Estate Appraisers for: LICENSED REAL ESTATE APPRAISER - Two thousand hours of appraisal experience. Obtained over a period of not less than 12 months. CERTIFIED RESIDENTIAL REAL ESTATE APPRAISER - Two thousand five hundred hours of appraisal experience obtained over a period of not less than 24 months. CERTIFIED GENERAL REAL ESTATE APPRAISER - Three thousand hours of appraisal experience obtained over a period of not less than 30 months is required. The applicant, for experience credit, must have accumulated a total of three thousand hours of appraisal experience of which at least one thousand five hundred hours must be in nonresidential appraisal work. I understand that experience documentation in the form of reports or file memoranda must be available to support the claim for experience, and must be produced on request. I further certify that everything listed on this experience report is true and accurate to the best of my knowledge. Print your name: Signature: Date: LICENSED CO-AUTHOR OR REVIEWER CERTIFICATION I hereby certify that the applicant is/was under my supervision for the period submitted and I personally reviewed his/her work on a regular basis and this report and the attached page(s) is correct to the best of my knowledge. Supervisor=s Name (printed) Supervisor=s Signature Supervisor=s License # Date NOTE: If more than one licensed Co-Author or Reviewer, attach a separate certification.
Vermont Board of Real Estate Appraisers - Certification of Appraisal Education Instruction: Complete the section that corresponds with the license level for which you have applied and attach to your certificates. State Licensed Appraiser Sponsor Date Taken Hours Basic Appraisal Principles - 30 Basic Appraisal Procedures - 30 15-Hour National USPAP Course - 15 Residential Market Analysis and Highest and Best Use - 15 Residential Site Valuation and Cost Approach - 15 Residential Sales Comparison and Income Approach - 30 Residential Report Writing and Case Studies - 15 Total Certified Residential Appraiser Sponsor Date Taken Hours Basic Appraisal Principles - 30 Basic Appraisal Procedures - 30 15-Hour National USPAP Course - 15 Residential Market Analysis and Highest and Best Use - 15 Residential Appraiser Site Valuation and Cost Approach - 15 Residential Sales Comparison and Income Approach - 30 Residential Report Writing and Case Studies - 15 Statistics Modeling and Finance - 15 Advanced Residential Applications and Case Studies - 15 Appraisal Subject Matter Electives -20 - (list electives below) Total Certified General Appraiser Sponsor Date Taken Hours Basic Appraisal Principles - 30 Basic Appraisal Procedures - 30 15-Hour National USPAP Course - 15 General Appraiser Market Analysis and Highest and Best Use - Statistics Modeling and Finance - 15 General Appraiser Sales Comparison Approach - 30 General Appraiser Site Valuation and Cost Approach - 30 General Appraiser Income Approach - 60 General Appraiser Report Writing and Case Studies - 30 Appraisal Subject Matter Electives - 30 - (list electives below) Total Elective Course Name Sponsor Date Taken Hours