Form LI-214/244 "Disciplinary Actions Disclosure" - Arizona

What Is Form LI-214/244?

This is a legal form that was released by the Arizona Department of Real Estate - a government authority operating within Arizona. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 1, 2019;
  • The latest edition provided by the Arizona Department of Real Estate;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form LI-214/244 by clicking the link below or browse more documents and templates provided by the Arizona Department of Real Estate.

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Download Form LI-214/244 "Disciplinary Actions Disclosure" - Arizona

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Arizona Department of Real Estate (ADRE)
DOUGLAS A. DUCEY
GOVERNOR
Licensing Division
www.azre.gov
JUDY LOWE
COMMISSIONER
100 North 15th Avenue ● Suite 201 ● Phoenix, Arizona ● 85007
DISCIPLINARY ACTIONS DISCLOSURE (LI-214/244)
ARS §§ 32-2123 and 32-2130 & AAC R4-28-301 and AAC R4-28-303
The Disciplinary Actions Disclosure is required by ADRE to determine qualifications and suitability of the licensee to hold an Arizona Real Estate
License. ANY AND ALL MISDEMEANOR AND FELONY convictions must be included for immediate past renewals.
Failure to answer these questions truthfully may result in disciplinary actions including, but not limited to, suspension, revocation and/or civil penalties
.
ARS §§ 32-2153(B) and 32-2160.01
Has the Applicant / Is the Applicant:
Had a professional or occupational license or registration of ANY kind denied, suspended, restricted, or revoked? (Drivers
 NO
 YES
1
License/CDL not included)
Had/Have an administrative order and/or ANY other disciplinary action taken against ANY license issued to them by any
2
 NO
 YES
local, state, or federal regulatory agency including the Arizona Department of Real Estate?
Had an action issued by the ADRE which resulted in an Accelerated Settlement Agreement (ASA)?
3
YES
NO
Voluntarily surrendered ANY professional or occupational license during the course of an investigation or disciplinary
 YES
NO
4
proceeding?
 NO
Entered into ANY consent decree, and/or had an injunction (either temporary or permanent), a suspension, an order
 YES
5
and/or a judgment issued which prohibited or restricted them from engaging in ANY profession or occupation?
Had any judgment and/or order against them by ANY court involving fraud, dishonesty, misrepresentation, unfair trade
6
 YES
 NO
practice, or moral turpitude?
Had any judgment and/or order entered against them by ANY court arising out of the conduct of any business in real
7
 YES
 NO
estate, cemetery property, timeshare intervals, or membership campgrounds?
Had ANY SUBDIVISION PUBLIC REPORT or REGISTRATION TO SELL real estate, timeshares, cemetery lots, or
8
 YES
 NO
campground memberships denied and/or suspended?
Had ANY payment made from the real estate recovery fund and/or ANY similar fund that was charged against them
9
 YES
 NO
and/or against a business for which they were the qualifying party?
Currently involved in ANY pending disciplinary hearings and/or other administrative actions, against ANY professional
10
 YES
 NO
and/or occupational licenses held in Arizona and/or in any other state?
Held, and/or currently holds 10% or more ownership and/or controlling interest in any business, corporation,
11
 YES
 NO
partnership, or limited liability company that would cause them to answer “YES” to any of the ABOVE questions.
Been convicted and/or entered into a plea agreement and/or a plea of NOLO CONTENDERE (no contest) to ANY felony in
12
Arizona and/or any other state, whether or not the plea or verdict was set aside, judgment or sentencing was deferred,
 YES
 NO
conviction was dismissed or expunged, or has been pardoned, or the conviction is being appealed?
Been convicted or entered into a plea agreement or a plea of NOLO CONTENDERE (no contest) to ANY misdemeanor in
Arizona or any other state, whether or not the plea or verdict was set aside, judgment or sentencing was deferred,
13
the conviction was dismissed or expunged, or has been pardoned, or the conviction is being appealed?
 YES
 NO
CONVICTIONS – DUI AND/OR RECKLESS DRIVING, EITHER MISDEMEANOR OR FELONY, MUST BE DISCLOSED
Minor traffic citations do not constitute a misdemeanor or felony offense.
CURRENTLY in a deferred period of judgment or sentencing, in a diversion program, and/or convicted of a Class 6
14
 YES
 NO
Undesignated Offense, which has not yet been designated as a felony or misdemeanor as of the date of this application?
15
CURRENTLY incarcerated, paroled, and/or on probation because of ANY conviction?
 YES
 NO
If the applicant answered YES to any questions 1 through 14, applicant must also answer the following:
Has the applicant previously disclosed the incident to ADRE in writing?
 YES
 NO
1
Approximate date of disclosure
Type of disclosure
2
If the incident and/or action has not previously been disclosed to the ADRE in writing, refer to the DISCLOSURE DOCUMENT CHECKLIST FORM
(LI-400) for a list of additional required documentation that must be submitted to ADRE before a renewal application is submitted for processing.
A fingerprint clearance card is required if there are any “YES” answers, other than a “YES” on question number 3.
ATTESTATION: I attest, under penalty of perjury, under the laws of the State of Arizona, that the foregoing answers and statements given in
this application are true and correct. I certify that at the time of ADRE license issuance, I will be 18 years of age or older. I certify that while
licensed, I will not violate any provisions of Real Estate Laws nor abuse the privileges of ADRE issued licenses.
Print Name
Signature of Applicant
Date
ADRE License#
Email Address
LI-214/244 Rev 8/2019
Arizona Department of Real Estate (ADRE)
DOUGLAS A. DUCEY
GOVERNOR
Licensing Division
www.azre.gov
JUDY LOWE
COMMISSIONER
100 North 15th Avenue ● Suite 201 ● Phoenix, Arizona ● 85007
DISCIPLINARY ACTIONS DISCLOSURE (LI-214/244)
ARS §§ 32-2123 and 32-2130 & AAC R4-28-301 and AAC R4-28-303
The Disciplinary Actions Disclosure is required by ADRE to determine qualifications and suitability of the licensee to hold an Arizona Real Estate
License. ANY AND ALL MISDEMEANOR AND FELONY convictions must be included for immediate past renewals.
Failure to answer these questions truthfully may result in disciplinary actions including, but not limited to, suspension, revocation and/or civil penalties
.
ARS §§ 32-2153(B) and 32-2160.01
Has the Applicant / Is the Applicant:
Had a professional or occupational license or registration of ANY kind denied, suspended, restricted, or revoked? (Drivers
 NO
 YES
1
License/CDL not included)
Had/Have an administrative order and/or ANY other disciplinary action taken against ANY license issued to them by any
2
 NO
 YES
local, state, or federal regulatory agency including the Arizona Department of Real Estate?
Had an action issued by the ADRE which resulted in an Accelerated Settlement Agreement (ASA)?
3
YES
NO
Voluntarily surrendered ANY professional or occupational license during the course of an investigation or disciplinary
 YES
NO
4
proceeding?
 NO
Entered into ANY consent decree, and/or had an injunction (either temporary or permanent), a suspension, an order
 YES
5
and/or a judgment issued which prohibited or restricted them from engaging in ANY profession or occupation?
Had any judgment and/or order against them by ANY court involving fraud, dishonesty, misrepresentation, unfair trade
6
 YES
 NO
practice, or moral turpitude?
Had any judgment and/or order entered against them by ANY court arising out of the conduct of any business in real
7
 YES
 NO
estate, cemetery property, timeshare intervals, or membership campgrounds?
Had ANY SUBDIVISION PUBLIC REPORT or REGISTRATION TO SELL real estate, timeshares, cemetery lots, or
8
 YES
 NO
campground memberships denied and/or suspended?
Had ANY payment made from the real estate recovery fund and/or ANY similar fund that was charged against them
9
 YES
 NO
and/or against a business for which they were the qualifying party?
Currently involved in ANY pending disciplinary hearings and/or other administrative actions, against ANY professional
10
 YES
 NO
and/or occupational licenses held in Arizona and/or in any other state?
Held, and/or currently holds 10% or more ownership and/or controlling interest in any business, corporation,
11
 YES
 NO
partnership, or limited liability company that would cause them to answer “YES” to any of the ABOVE questions.
Been convicted and/or entered into a plea agreement and/or a plea of NOLO CONTENDERE (no contest) to ANY felony in
12
Arizona and/or any other state, whether or not the plea or verdict was set aside, judgment or sentencing was deferred,
 YES
 NO
conviction was dismissed or expunged, or has been pardoned, or the conviction is being appealed?
Been convicted or entered into a plea agreement or a plea of NOLO CONTENDERE (no contest) to ANY misdemeanor in
Arizona or any other state, whether or not the plea or verdict was set aside, judgment or sentencing was deferred,
13
the conviction was dismissed or expunged, or has been pardoned, or the conviction is being appealed?
 YES
 NO
CONVICTIONS – DUI AND/OR RECKLESS DRIVING, EITHER MISDEMEANOR OR FELONY, MUST BE DISCLOSED
Minor traffic citations do not constitute a misdemeanor or felony offense.
CURRENTLY in a deferred period of judgment or sentencing, in a diversion program, and/or convicted of a Class 6
14
 YES
 NO
Undesignated Offense, which has not yet been designated as a felony or misdemeanor as of the date of this application?
15
CURRENTLY incarcerated, paroled, and/or on probation because of ANY conviction?
 YES
 NO
If the applicant answered YES to any questions 1 through 14, applicant must also answer the following:
Has the applicant previously disclosed the incident to ADRE in writing?
 YES
 NO
1
Approximate date of disclosure
Type of disclosure
2
If the incident and/or action has not previously been disclosed to the ADRE in writing, refer to the DISCLOSURE DOCUMENT CHECKLIST FORM
(LI-400) for a list of additional required documentation that must be submitted to ADRE before a renewal application is submitted for processing.
A fingerprint clearance card is required if there are any “YES” answers, other than a “YES” on question number 3.
ATTESTATION: I attest, under penalty of perjury, under the laws of the State of Arizona, that the foregoing answers and statements given in
this application are true and correct. I certify that at the time of ADRE license issuance, I will be 18 years of age or older. I certify that while
licensed, I will not violate any provisions of Real Estate Laws nor abuse the privileges of ADRE issued licenses.
Print Name
Signature of Applicant
Date
ADRE License#
Email Address
LI-214/244 Rev 8/2019