Va Experience Verification Form – Fill Out and Use This PDF

Commonwealth of Virginia

Department of Professional and Occupational Regulation 3600 West Broad Street

Richmond, Virginia 23230-4917 (804) 367-8526

www.dpor.virginia.gov

Real Estate Board

EXPERIENCE VERIFICATION FORM

This form must be completed by a principal broker or supervising broker who can attest to the applicant’s real estate sales

experience during the required 36-month (salesperson) or 48-month (broker) time-period.

Photocopies of this form may be used to accommodate different brokers that have supervised you during the required 36 or 48 months.

+PLEASE NOTE: APPLICANTS CANNOT VERIFY THEIR OWN EXPERIENCE.

Salesperson Applicants (reciprocity applicants only)

18 VAC 135-20-60.6 of the Real Estate Board Regulations requires reciprocity applicants for real estate salesperson licenses to either 1) be actively engaged as a real estate salesperson for 12 of the 36 months preceding their application for licensure or 2) meet educational requirements that are substantially equivalent to those required in Virginia.

Broker Applicants (examination and reciprocity applicants)

18VAC 135-20-40.2 and 18 VAC 135-20-60.6 of the Real Estate Board Regulations require applicants for real estate broker licenses to be actively engaged as a real estate salesperson and/or broker for 36 of the 48 months preceding their application for licensure. Out-of-state licensed principal broker or sole proprietor applicants reciprocating to Virginia may ask a licensee or attorney to attest to their experience.

Applicant’s Legal Name

First	Middle	Last	Generation
			(SR, JR, III)

Firm Name

Trade Name

Firm’s Principal Broker

First	Middle	Last	Generation
			(SR, JR, III)

above-named applicant has been employed by, or associated with, a real estate firm and has been actively engaged

(employed or associated with a broker) in performing those activities defined in §54.1, Chapter 21 of the Code of Virginia

(see back of page) as a real estate salesperson and/or broker for an average of at least 40 hours per week for a period of

	months from		to			.
	Broker’s Signature				Principal or Supervising Broker’s License Number

APPLICATIONS AND SIGNATURES MUST BE ORIGINAL. FAXES AND COPIES WILL NOT BE

ACCEPTED.

02EXP ( 08/17/05)

Real Estate Board/EXP FORM

§54.1-2100. Real estate broker defined. - For the purposes of this chapter, “real estate broker”

means any person, or business entity, including, but not limited to, a partnership, association, corporation or limited liability company, who, for compensation or valuable consideration (i) sells or offers for sale, buys or offers to buy, or negotiates the purchase or sale or exchange of real estate, including units or interest in condominium, cooperative interest as defined in §55-426, or time -shares in a time -share program even though they may be deemed to be securities, or (ii) leases or offers to lease, or rents or offers for rent, any real estate or the improvements thereon for others. (Code 1950, §54-730; 1974, c. 409; 1982, c. 440; 1984, c. 283; 1988, c. 765; 1996, c.993; 2001, c. 548.)

§54.1-2101. Real estate salesperson defined. - For the purposes of this chapter, “real estate

salesperson” means any person, or business entity of not more than two persons unless related by blood or marriage, who for compensation or valuable consideration is employed either directly or indirectly by, or affiliated as an independent contractor with, a real estate broker, to sell or offer to sell, or to buy or offer to buy, or to negotiate the purchase, sale or exchange of real estate, or to lease, rent or offer for rent any real estate, or to negotiate leases thereof, or of the improvements thereon. (Code 1950, §54-731; 1974, c. 685; 1978, c. 138; 1984, c. 201; 1988, c. 765; 1992, c. 84; 1996, c. 993.)

“Actively engaged” means active licensure with a licensed real estate firm or sole proprietorship in performing those activities defined in §§54.1-2100 and 54.1-2101 of the Code of Virginia for an average of at least 40 hours per week.

02EXP ( 08/17/05)

Real Estate Board/EXP FORM