7/31/2019 Application Form for Real Estate Salesperson1

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PERSONAL DATAPERSONAL DATAPERSONAL DATAPERSONAL DATA

Have you ever been convicted by final judgment before any court, military tribunal oradministrative body? YES NO( if yes, please attach a copy of the decision)EDUCATIONAL DATAEDUCATIONAL DATAEDUCATIONAL DATAEDUCATIONAL DATA

Name of School Location Course/DegreeCompleted

FROM(MM/YY)

TO(MM/YY)

Elementary

High School

College

Others

NAME OF BROKERNAME OF BROKERNAME OF BROKERNAME OF BROKER LICENSE NO.LICENSE NO.LICENSE NO.LICENSE NO. REGISTRATION DATEREGISTRATION DATEREGISTRATION DATEREGISTRATION DATE VVVVALIDITY DATEALIDITY DATEALIDITY DATEALIDITY DATE SIGNATURESIGNATURESIGNATURESIGNATURE

`

EMPLOYMENT RECORDEMPLOYMENT RECORDEMPLOYMENT RECORDEMPLOYMENT RECORD

OFFICEOFFICEOFFICEOFFICE POSITION HELDPOSITION HELDPOSITION HELDPOSITION HELD SPECIFIC WORK/FUNCTIONSPECIFIC WORK/FUNCTIONSPECIFIC WORK/FUNCTIONSPECIFIC WORK/FUNCTIONFROM

(mm/dd/yy)TO

(mm/dd/yy)

ACTION TAKENACTION TAKENACTION TAKENACTION TAKEN ACTION TAKEN BY THE BOARDACTION TAKEN BY THE BOARDACTION TAKEN BY THE BOARDACTION TAKEN BY THE BOARD

Remarks: _____________ CHAIRCHAIRCHAIRCHAIRMANMANMANMAN ________________________________________________________________

_____________________ MEMBERMEMBERMEMBERMEMBER ________________________________________________________________

_____________________ MEMBERMEMBERMEMBERMEMBER ________________________________________________________________

Processed by: ___________ MEMBERMEMBERMEMBERMEMBER ________________________________________________________________

Date: ___________ MEMBERMEMBERMEMBERMEMBER ________________________________________________________________

ACTION TAKEN BY CASHIERACTION TAKEN BY CASHIERACTION TAKEN BY CASHIERACTION TAKEN BY CASHIER

Amount: _____________Amount: _____________Amount: _____________Amount: _____________ Date: _________________Date: _________________Date: _________________Date: _________________

O.R. No: _____________O.R. No: _____________O.R. No: _____________O.R. No: _____________ Issued by: _____________Issued by: _____________Issued by: _____________Issued by: _____________

LAST NAME FIRST NAME MIDDLE NAME

MALE FEMALECITIZENSHIP CIVIL STATUS

SINGLE MARRIEDWIDOWED SEPARATED

DATE OF BIRTH(mm/dd/yy)

PERMANENT MAILING ADDRESS ZIP CODE

PLACE OF BIRTH TELEPHONE /CELL PHONE NO/ EMAIL ADDRESS

SPOUSES NAME & CITIZENSHIP FATHERS NAME & CITIZENSHIP MOTHERS NAME & CITIZENSHIP

Republic of the Philippines

Professional Regulation CommissionManila, Philippines

P R O F E S S I O N A L R E G U L A T O R Y B O A R D O FP R O F E S S I O N A L R E G U L A T O R Y B O A R D O FP R O F E S S I O N A L R E G U L A T O R Y B O A R D O FP R O F E S S I O N A L R E G U L A T O R Y B O A R D O F

R E A L E S T A T E S E R V I C ER E A L E S T A T E S E R V I C ER E A L E S T A T E S E R V I C ER E A L E S T A T E S E R V I C E

Paste hereyour recent

PASSPORT SIZEcolored picturewith complete

nametag in whitebackground

A P P L I C A T I O N F O RA P P L I C A T I O N F O RA P P L I C A T I O N F O RA P P L I C A T I O N F O R A C C R E D I T A T I O N A SA C C R E D I T A T I O N A SA C C R E D I T A T I O N A SA C C R E D I T A T I O N A S

R E A L E S T A T E S A L E S P E R S O NR E A L E S T A T E S A L E S P E R S O NR E A L E S T A T E S A L E S P E R S O NR E A L E S T A T E S A L E S P E R S O N

Applicants Signature

Date Accomplished

Subscribed and sworn to before this ________ day of ___________ 20 ____ at ____________. Affiant

applicant exhibited to me his Community Tax Certificate No. _______________ issued at

___________________ on ____________________.__________________________________

PRC ADMINISTERING OFFICER

DOCUMENTARY STAMPDOCUMENTARY STAMPDOCUMENTARY STAMPDOCUMENTARY STAMP

PRC APP Form No. 004-b (Aug. 2011)

ACCREDITATION FOR SALESPERSONACCREDITATION FOR SALESPERSONACCREDITATION FOR SALESPERSONACCREDITATION FOR SALESPERSON

FOLLOWFOLLOWFOLLOWFOLLOW----UP SLIPUP SLIPUP SLIPUP SLIP

O. R. No. ________________Amount Paid: ____________Date Paid: _____________

NAME: __________________________________NAME: __________________________________NAME: __________________________________NAME: __________________________________

DATE OF FILING: _________________________DATE OF FILING: _________________________DATE OF FILING: _________________________DATE OF FILING: _________________________

Please verify approval of your application and resolution number at the PRC website: prc.gov.ph (news & event) or call (02)7351533 after 3 months.

_________________________

Application Processor/Date

I HEREBY CERTIFY that the information and/orI HEREBY CERTIFY that the information and/orI HEREBY CERTIFY that the information and/orI HEREBY CERTIFY that the information and/or

statements in this application including the documents submittedstatements in this application including the documents submittedstatements in this application including the documents submittedstatements in this application including the documents submittedin suppin suppin suppin support thereof are all true and correct to my own knowledge,ort thereof are all true and correct to my own knowledge,ort thereof are all true and correct to my own knowledge,ort thereof are all true and correct to my own knowledge,

and that I am fully aware that any false information or stateand that I am fully aware that any false information or stateand that I am fully aware that any false information or stateand that I am fully aware that any false information or statementmentmentment

in this application and /or in thein this application and /or in thein this application and /or in thein this application and /or in the attachmentsattachmentsattachmentsattachments theretotheretotheretothereto shall rendershall rendershall rendershall render

me liable for criminal prosecution and /or administrative sanctme liable for criminal prosecution and /or administrative sanctme liable for criminal prosecution and /or administrative sanctme liable for criminal prosecution and /or administrative sanctionionionion.

THUMBMARKTHUMBMARKTHUMBMARKTHUMBMARK

NOT FOR SALE

REPRODUCTION ISALLOWED

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1. Fill-up application form together with required documents for pre-evaluation to the Officeof the Secretary, PRBs or of the Assistant Secretary, PRBs (3

rdFlr., Main Bldg.) at the

PRC Central Office and Regional Offices processing counters.

2. Proceed to the cashier for payment of fees P600.00 (Ground Flr., Main Bldg.) at theCentral Office or Cashiers Window at the Regional Offices.

3. Proceed to the Customer Service Center for documentary stamp. (Ground Flr., AnnexBldg.) / designated counter at the Regional Offices.

4. Submit duly accomplished application form and requirements to the Office of theAssistant Secretary (3rd Flr.) / designated counter at the Regional Offices.

5. Verify status of application at the PRC website: prc.gov.ph (news & event).

1. For Real Estate Salesperson with no DTI / HLURB Registration.

1 Original and Photocopy of NSO Certificate of Live Birth /Birth Certificate

2. Original and Photocopy of NSO Marriage Certificate / Contract(for Married female only)

3. Original and Notarized Certificate of Educational Attainment on

the Completion of at least two (2) years of College4. Original NBI Clearance (Valid)

5. Original and Notarized Certification of twelve (12) credit units

on Real Estate Brokerage.

2 For Real Estate Salesperson with DTI / HLURB Registration

(Deadline: December 31, 2011)

1. Original and Photocopy of NSO Certificate of Live Birth /

Birth Certificate

2. Original and Photocopy of NSO Marriage Certificate / Contract(for Married female only)

3. Original and Notarized Certificate of Educational Attainment (at

least H.S. Diploma)

4. Original NBI Clearance (Valid)5. Original and Notarized Certification of his /her DTI Licensed

Estate Broker or HLURB Registered Real Estate Developer

6. Original and Photocopy of DTI / HLURB Certificate ofRegistration as Salesperson

7. Original and Notarized Certification of a least One Hundred

Twenty (120) Hours of training and seminar to be issued bythe Employer or Provider (60 hrs. classroom lectures or

seminars and 60 hrs. of training or fieldwork).

3. Real Estate Salesperson with at Least Three (3) years of Active

Practice (Deadline: December 31, 2011)

1. Original and Photocopy of NSO Certificate of Live Birth

/ Birth Certificate

2. Original and Photocopy of NSO Marriage Certificate / Contract(for Married female only)

3. Original and Notarized Certificate of Educational Attainment (atleast H.S. Diploma)

4. Original NBI Clearance (Valid)

5. Original and Notarized Certification of his /her Supervising RealEstate Broker or HLURB registered Real Estate Developer

6. Original and Notarized Certification of a least One Hundred

Twenty (120) Hours of training and seminar to be issued by

the Employer or Provider (60 hrs. classroom lectures orseminars and 60 hrs. of training or fieldwork).

STEPS IN FILING APPLICATION FOR ACCREDITATION AS A REAL ESTATE SALESPERSON

DOCUMENTS REQUIRED FOR REAL ESTATE SALESPERSON