Republic of
the Philippines
DEPARTMENT OF TRADE AND INDUSTRY
Trade and Industry Regulatory Division
Cebu Provincial Office 3/F LDM Building, Legaspi Street, Cebu City
Phone: (6332) 2557084, 2557086 Fax: (6332) 2557609
_______________________
( Date )
-
During the past twelve(12)months I have not been convicted by a competent
court for any violation of law, ordinance or regulation involving
cheating, fraud, deceit, misrepresentation or wrongful conversion
of property or for any crime involving moral turpitude. (If the preceeding
statement is in the affirmative, a certified copy of the decision
of the court shall be attached hereto.)
-
I
have not employed unlicensed agents nor violated any provision of
Domestic Trade Administrative Order No. 1, dated April 2, 1975.
-
I
was originally licensed as:
a. REAL ESTATE SALESMAN on ____________________, 20_______ under ______________
b. REAL ESTATE BROKER on ______________________ , 20 ______ under
______________
c. REAL ESTATE APPRAISER on ___________________ , 20 ______ under
______________
d. REAL ESTATE CONSULTANT on __________________ , 20 ______ under
______________
- FOR REAL ESTATE
BROKERS; APPRAISERS AND CONSULTANTS:
a. I/We have the following broker (REB) and/or salesman (RES) licensed
under me/us:
|
NAME
OF (RES) or (RES)
|
REB
or RES LICENSE NO.
|
DATE
ORIGINALLY
LICS'D WITH APPLICANT
|
| (1) _____________________ |
_________________ |
________________ |
| (2) _____________________ |
_________________ |
________________ |
| (3) _____________________ |
_________________ |
________________ |
b. I/We do not have
any real estae salesman licensed under me/us because ________________
_______________________________________________________________________________
c. I/We have the following branch office/s:
|
LOCATION/S
OF BRANCH OFFICE/S
|
NAME
OF BRANCH MANAGER/S
|
REB
or RES LICENSE NO.
|
|
(1)
_____________________
|
__________________
|
_______________
|
|
(2) _____________________
|
__________________
|
_______________
|
______________________________
SIGNATURE
CONFORMITY
OF BROKER-EMPLOYER
(For Real Estate Salesman)
________________________
Signature
________________________
NAME IN PRINT
REB License No.__________
Renewal ________________ |
Office Address & Tel No. ________________________________
Res. Address & Tel No. _________________________________
RE _________ LIC No. ___________ RENEWAL _____ 19 ____
Res. Cer No. _______________ Issued on __________________
at ___________________________________________________
TAN ____________________ PRT No. _____________________ |
|