Form REPL-19-0003 "In-state Home Inspector Application" - Ohio

What Is Form REPL-19-0003?

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

Form Details:

  • Released on April 30, 2021;
  • The latest edition provided by the Ohio Department of Commerce;
  • 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 REPL-19-0003 by clicking the link below or browse more documents and templates provided by the Ohio Department of Commerce.

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Download Form REPL-19-0003 "In-state Home Inspector Application" - Ohio

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INSTRUCTIONS FOR CRIMINAL RECORDS CHECK
When an initial application for an Ohio home inspector license is filed with the Division, each applicant is required
to complete a criminal records check of both state and FBI records.
Electronic fingerprints must be taken by a Webcheck® user (a business, government agency or private
entity that provides criminal record check services) approved by the Bureau of Criminal Identification and
Investigation (BCI&I). Out of state applicants should consult the additional information link found below.
Applicants must contact and arrange with a Webcheck® user to have electronic fingerprints taken and
submitted to BCI&I using the Webcheck® system. Government issued photo identification should be taken
to the Webcheck® location. Some Webcheck® users can only submit fingerprints for a state records check
and not an FBI records check. Applicants should confirm the Webcheck® user can submit both state and
FBI fingerprints to BCI&I.
A list of Webcheck® users may be found on the web at:
https://www.ohioattorneygeneral.gov/Business/Services-for-Business/WebCheck/Webcheck-
Community-Listing
Ohio Attorney General’s Office allows for limited exceptions to providing electronic fingerprints to a
Webcheck® user. For those applicants who cannot comply with electronic fingerprints taken by a
Webcheck® user, please contact BCI&I at 877-224-0043 to obtain a state fingerprint card and a FBI
fingerprint card along with an exemption form. Please consult the exemption form carefully to see if an
exception applies. Please carefully review all BCI&I instructions to ensure proper processing of the
applicant’s fingerprints.
Additional information may be found at:
https://www.ohioattorneygeneral.gov/FAQ/Background-Check-FAQs.aspx
(frequently asked questions)
or obtained from BCI&I at (877) 224-0043 or P.O. Box 365 London, Ohio 43140
Fingerprints must be provided within ten (10) days after the date of filing of the application, and fingerprints
should not be taken before the filing of the application with the Division of Real Estate. Fingerprints must
be sent to BCI&I at P.O. Box 365, London, Ohio 43140. Any fingerprints sent directly to the Division of
Real Estate will be destroyed, and applicants will be required to complete and submit a new set of
fingerprints to BCI&I.
Applicants must pay all fees associated with the criminal records check at the time the fingerprints are taken.
The BCI&I Reason Code is 4764.07 and 121.08 & the FBI Reason Code is 121.08.
BCI&I must directly send the results (state and FBI criminal records check) to the Division at this address:
Division of Real Estate and Professional Licensing
th
77 S High St., 20
Fl.
Columbus, OH 43215
You must use the correct address for the Division to avoid your application being delayed.
BCI&I generally submits results to the Division within thirty (30) days of BCI&I’s receipts of the fingerprints.
Failure to timely comply with the criminal records check requirement may result in the denial of an
application.
Home Inspector Program
614-466-4100
77 South High Street
Fax 614-644-0584
th
20
Floor
TTY/TDD 800-750-0750
Columbus, Ohio 43215
Anne M. Petit, Superintendent
com.ohio.gov/real
An Equal Opportunity Employer and Service Provider
INSTRUCTIONS FOR CRIMINAL RECORDS CHECK
When an initial application for an Ohio home inspector license is filed with the Division, each applicant is required
to complete a criminal records check of both state and FBI records.
Electronic fingerprints must be taken by a Webcheck® user (a business, government agency or private
entity that provides criminal record check services) approved by the Bureau of Criminal Identification and
Investigation (BCI&I). Out of state applicants should consult the additional information link found below.
Applicants must contact and arrange with a Webcheck® user to have electronic fingerprints taken and
submitted to BCI&I using the Webcheck® system. Government issued photo identification should be taken
to the Webcheck® location. Some Webcheck® users can only submit fingerprints for a state records check
and not an FBI records check. Applicants should confirm the Webcheck® user can submit both state and
FBI fingerprints to BCI&I.
A list of Webcheck® users may be found on the web at:
https://www.ohioattorneygeneral.gov/Business/Services-for-Business/WebCheck/Webcheck-
Community-Listing
Ohio Attorney General’s Office allows for limited exceptions to providing electronic fingerprints to a
Webcheck® user. For those applicants who cannot comply with electronic fingerprints taken by a
Webcheck® user, please contact BCI&I at 877-224-0043 to obtain a state fingerprint card and a FBI
fingerprint card along with an exemption form. Please consult the exemption form carefully to see if an
exception applies. Please carefully review all BCI&I instructions to ensure proper processing of the
applicant’s fingerprints.
Additional information may be found at:
https://www.ohioattorneygeneral.gov/FAQ/Background-Check-FAQs.aspx
(frequently asked questions)
or obtained from BCI&I at (877) 224-0043 or P.O. Box 365 London, Ohio 43140
Fingerprints must be provided within ten (10) days after the date of filing of the application, and fingerprints
should not be taken before the filing of the application with the Division of Real Estate. Fingerprints must
be sent to BCI&I at P.O. Box 365, London, Ohio 43140. Any fingerprints sent directly to the Division of
Real Estate will be destroyed, and applicants will be required to complete and submit a new set of
fingerprints to BCI&I.
Applicants must pay all fees associated with the criminal records check at the time the fingerprints are taken.
The BCI&I Reason Code is 4764.07 and 121.08 & the FBI Reason Code is 121.08.
BCI&I must directly send the results (state and FBI criminal records check) to the Division at this address:
Division of Real Estate and Professional Licensing
th
77 S High St., 20
Fl.
Columbus, OH 43215
You must use the correct address for the Division to avoid your application being delayed.
BCI&I generally submits results to the Division within thirty (30) days of BCI&I’s receipts of the fingerprints.
Failure to timely comply with the criminal records check requirement may result in the denial of an
application.
Home Inspector Program
614-466-4100
77 South High Street
Fax 614-644-0584
th
20
Floor
TTY/TDD 800-750-0750
Columbus, Ohio 43215
Anne M. Petit, Superintendent
com.ohio.gov/real
An Equal Opportunity Employer and Service Provider
The Division is not permitted to send an applicant a copy of their background check. To obtain a
copy of your FBI Identification Record, an applicant may send a request to:
FBI’s CJIS Division
Attn: Record Request
1000 Custer Hollow Rd.
Clarksburg, WV 26306
You are required to provide the following:
Your written request.
Payment for a processing fee, either by certified check or money order made payable to the Treasury of the
United States, or a credit card. For payment information, refer to www2.fbi.gov/hq/cjisd/fprequest.htm.
A current, original ten print fingerprint submission (not previously processed) taken by a local law
enforcement agency and bearing your name, date of birth, and place of birth.
If, after reviewing your record, you believe it is inaccurate or incomplete, you may challenge
the record by contacting the agency (or agencies) that originally submitted the information
or by sending your challenge to:
FBI’s CJIS Division
Attn: Correspondence Group
1000 Custer Hollow Rd
Clarksburg, WV 26306
Individuals requesting a Challenge and Review of their Ohio criminal history record, should
utilize the following procedure.
A written request for a challenge & review must be submitted to the Ohio Bureau of Criminal Identification
& Investigation, Identification Division. This request must include a brief explanation for the reason the
record is being challenged, the individuals name and complete mailing address.
The individual must be fingerprinted by a law enforcement or criminal justice agency to provide positive
identification. All data fields on the fingerprint card must be completely filled out. To ensure expeditious
processing the reason fingerprinted data field should contain “Challenge & Review” (There is no fee charge
for this service).
The required items listed above should be mailed together to:
Ohio Bureau of Criminal Identification & Investigation
Attn: Challenge & Review
PO Box 365
London, Ohio 43140
Home Inspector Program
614-466-4100
77 South High Street
Fax 614-644-0584
th
20
Floor
TTY/TDD 800-750-0750
Columbus, Ohio 43215
Anne M. Petit, Superintendent
com.ohio.gov/real
An Equal Opportunity Employer and Service Provider
Initial License Application
Home Inspector License
Fee: $250
Please make check or money order made payable to:
FOR DIVISION USE ONLY
OHIO DIVISION OF REAL ESTATE
Mail in application and payment to:
Ohio Division of Real Estate
77 S High St., 20th Fl
Columbus, OH 43215
Section 1: Applicant Information
First Name
Middle Initial
Last Name
Home Address
Social Security Number
City
State
Zip Code
Date Of Birth
Home Phone
Email Address
Year Of High School Graduation/GED
Legal Status (check applicable)
Legal Alien* – If legal alien, attach proof of being a legal alien
I am a:
US Citizen
Section 2: Current Company Information
Company Name
Doing Business As Name
Business Address
City
State
Zip Code
Employer Identification Number
Ohio Secretary Of State Entity#
Phone Number
Company Business Structure (check one)
Corporation
LLC
Partnership
Sole Proprietor
Date Business Opened
Are You The Owner/Operator Of The Company?
Yes
No
Section 3: Comprehensive General/Commercial General Liability Insurance
Please attach a copy of the Certificate of Insurance with this application.
Must not be less than $100,000 per occurrence & not less than $300,000 aggregate limit.
Insurance Provider
Policy Number
Business Address
Phone Number
City
State
Zip Code
*If you are living in the US, Federal Law [8 USCS 1621], limits the issuance of professional licenses to US citizens or aliens lawfully admitted in the US.
Home Inspector Program
614-466-4100
77 South High Street
Fax 614-644-0584
th
20
Floor
TTY/TDD 800-750-0750
Columbus, Ohio 43215
Anne M. Petit, Superintendent
com.ohio.gov/real
REPL-19-0003
An Equal Opportunity Employer and Service Provider
Updated
4/30/21
Ohio Department of Commerce
REPL-19-0003
Section 4: Ethical Conduct & Legal History
Please attach to this application any materials or explanations for any questions answered yes.
Have you had a credential to act as a home inspector refused, denied, canceled, surrendered
YES
NO
or revoked for any reason in any jurisdiction?
Have you had any professional or occupational credential disciplined in any way in any
YES
NO
jurisdiction?
YES
NO
Have you been notified that you are under investigation in any jurisdiction?
Have you ever been refused or denied any professional or occupational credential in any
YES
NO
jurisdiction?
YES
NO
Are you currently the subject of any unsatisfied judgments?
Excluding minor traffic violations (e.g. speeding tickets), have you ever been convicted of,
YES
NO
plead guilty to, or been granted intervention in lieu of, a conviction in any jurisdiction?
Section 5: Out of State Home Inspector Credentials
If currently maintaining or previously maintained an out of state home inspector credential, then complete this section.
State
Credential Type
Credential #
Expiration date
Standing
Is the license in good
standing?
YES
NO
Is the license in good
standing?
YES
NO
Is the license in good
standing?
YES
NO
Is the license in good
standing?
YES
NO
Is the license in good
standing?
YES
NO
Is the license in good
standing?
YES
NO
Section 6: Applicant Certification
I certify that all information or statements provided in this application and in attachment materials is complete and
accurate and understand this application and the information contained therein is public record pursuant to Ohio Revised
Code Section 149.43.
I understand any false information or statements in this application and attached materials may subject me to
criminal prosecution and loss of the Ohio home inspector license.
I agree to comply with all requirements found in Ohio Revised Code Chapter 4764 and its corresponding rules and
policies. I understand the grounds for any disciplinary action that may be initiated under Ohio Revised Code Chapter
4764.
I certify I am at least 18 years of age and have graduated high school or received a high school equivalences
(GED) as defined in section 4109.06 of the Revised Code.
I agree to maintain a comprehensive or commercial general liability insurance policy in accordance with ORC
4764.11.
I am executing this certification voluntarily, knowingly and intelligently and with full knowledge of its significance.
PRINT NAME
SIGNATURE
DATE
REPL-19-0003
Updated
4/30/21
Ohio Department of Commerce
REPL-19-0003
Section 7: Affidavit
I,
having been duly sworn and cautioned and for my sworn
affidavit state I have had the opportunity to seek legal counsel and obtain representation and/or advice prior
to executing this affidavit, and I am executing this affidavit voluntarily, knowingly and intelligently and with full
knowledge of its significance. I further state I satisfied all of the requirements found below by checking the
box next to the corresponding requirements and attaching to this application any required proof
demonstrating satisfaction of the requirement.
Requirements satisfied:
I have successfully passed the National Home Inspector Examination (NHIE) within two (2) years prior
to the date of this application (provide copy of certificate of completion).
I have successfully completed eighty (80) hours of classroom or online home inspector qualifying
education requirements pursuant to Ohio Revised Code Section 4764.05(D)(5) (complete section A).
I have successfully completed the experience requirements established in Ohio Revised Code Section
4764.05(D)(6) by completing one (1) of the following: (Please indicate which requirement has been
completed by checking the appropriate box below.)
Successfully completed forty (40) hours of work in home inspection within twelve (12) months
prior to the date of this application and have successfully completed one (1) peer review session
(complete section B).
Successfully completed an approved interactive curriculum of experience offering within twelve
(12) months prior to the date of this application (provide copy of certificate of completion) and
have successfully completed one (1) peer review session (complete section B only).
I have successfully completed ten (10) parallel inspections (complete section C).
Applicant Signature
Sworn to and subscribed before me, a Notary Public, this
day of
, 20
.
(NOTARY SEAL)
Signature Of Notary
REPL-19-0003
Updated
4/30/21