HISTORY: Are you applying for a license as a Georgia Resident? Yes No Are you a veteran with at least one year active duty? Yes No Have you Ever been licensed in another State as a broker or sales person? Yes No If yes, which state: Under what name: Have you ever held or do you hold a real estate license in Georgia? Yes No If yes, give license number Name (if different) Are you a high school graduate or holder of a General Education Development (GED) certificate? Yes No Have you ever been convicted of, pled nolo contendere to, or been grated first offender treatment upon being charged with (1) any criminal offense other than a traffic violation or (2) any traffic violation that involved driving under the influence of alcohol or drugs, homicide, or feticide by vehicle, fleeing the scene of an accident, attempting to elude a police officer, or impersonating a law enforcement officer? Yes No Have you ever been disciplined by the Georgia Real Estate Commission or any state or federal licensing agency or authority which regulates any profession? Yes No Are there any criminal charges or licensing disciplinary proceedings ending against you at this time? Yes No Are you currently required by any court, administrative or contempt order to make child support payments? Yes No
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