Ohio Department of Commerce Division of Real Estate & Professional Licensing Ted Strickland Governor 77 South High Street • 20th Floor Columbus, OH 43215-6133 (614) 466-4100 Fax:(614) 644-0584 www.com.ohio.gov Kimberly A. Zurz Director REQUEST FOR LICENSE HISTORY/LETTER OF GOOD STANDING FOR OHIO APPRAISER OR REAL ESTATE LICENSE Fee: $20.00 Name of Licensee: _____________________________________________ Type of License: ______________________________ (Appraiser/Real Estate License) License No._______________________ (Information is required to verify license history. Without the license number the Division may not be able to locate records if not currently licensed) Mail Certificate to (name and address): _____________________________ _____________________________________________________________ _____________________________________________________________ In the space provided below, list any additional information that should be included with your request: ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ Mail request and $20 fee to: Ohio Division of Real Estate 77 S. High Street, 20th Floor Columbus, OH 43215-6133 If you have any questions, please contact the Division at 614-466-4100. FINANCIAL INSTITUTIONS INDUSTRIAL COMPLIANCE LABOR & WORKER SAFETY LIQUOR CONTROL REAL ESTATE & PROFESSIONAL LICENSING SECURITIES STATE FIRE MARSHAL UNCLAIMED FUNDS COM (Rev. 8/2008) “An Equal Opportunity Employer and Service Provider” Page 1 of 1 American LegalNet, Inc. www.FormsWorkflow.com