Form IL505-0362 "120-day Student Leasing Agent Permit/Application" - Illinois

What Is Form IL505-0362?

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

Form Details:

  • Released on January 1, 2016;
  • The latest edition provided by the Illinois Department of Financial and Professional Regulation;
  • 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 printable version of Form IL505-0362 by clicking the link below or browse more documents and templates provided by the Illinois Department of Financial and Professional Regulation.

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Download Form IL505-0362 "120-day Student Leasing Agent Permit/Application" - Illinois

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120-DAY STUDENT LEASING AGENT PERMIT/APPLICATION
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
Division of Real Estate
rd
320 West Washington Street, 3
Floor
Springfield, Illinois 62786
Real Estate Licensing 800/560-6420
472
120-DAY STUDENT LEASING AGENT PERMIT/APPLICATION
STUDENT LEASING AGENT INFORMATION
(Note: Must be submitted within 24 hours of employment)
NAME __________________________________________ SOC SEC NO._____________________
MAILING ADDRESS ________________________________________________________________
CITY, COUNTY, STATE, ZIP CODE ___________________________________________________
DATE OF BIRTH
____________
TELEPHONE NO. ( _ _ _ ) _ _ _ - _ _ _ _
EMAIL ADDRESS: _________________________________________________
SPONSOR/FIRM INFORMATION
SPONSOR NAME ___________________________________ LICENSE NO. ___________________
D/B/A (IF APPLICABLE) ______________________________________________________________
MAILING ADDRESS _________________________________________________________________
CITY, STATE, ZIP CODE _____________________________________________________________
TELEPHONE NUMBER ( _ _ _ ) _ _ _ - _ _ _ _
I/We certify that the Student Leasing Agent Applicant is at least 18 years of age, has not been a Student Leasing Agent
permit holder or a Leasing Agent licensee within the past 2 years, and has a high school diploma or an equivalent course of
study (i.e., GED). I/We further certify that the Student Leasing Agent Applicant shall be subject to the standards of
practice and disciplinary provisions of a Leasing Agent licensee and the Managing Broker shall be responsible for the
activities and actions of the Student Leasing Agent as if the Student Leasing Agent was a Leasing Agent licensee.
_____________________________________
_______________________________
Student Leasing Agent Signature
Managing Broker Signature
_____________________________________
_______________________________
Date
Managing Broker License No.
$25 Fee Payable to the Illinois Department of Financial and Professional Regulation is required with this Form.
320 WEST WASHINGTON STREET SPRINGFIELD, ILLINOIS 62786 PHONE: 800-560-6420 FAX: 217-782-3390 TTY: 866-325-4949
http://www.idfpr.com
IL 505-0362 (Revised 1/16)
120-DAY STUDENT LEASING AGENT PERMIT/APPLICATION
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
Division of Real Estate
rd
320 West Washington Street, 3
Floor
Springfield, Illinois 62786
Real Estate Licensing 800/560-6420
472
120-DAY STUDENT LEASING AGENT PERMIT/APPLICATION
STUDENT LEASING AGENT INFORMATION
(Note: Must be submitted within 24 hours of employment)
NAME __________________________________________ SOC SEC NO._____________________
MAILING ADDRESS ________________________________________________________________
CITY, COUNTY, STATE, ZIP CODE ___________________________________________________
DATE OF BIRTH
____________
TELEPHONE NO. ( _ _ _ ) _ _ _ - _ _ _ _
EMAIL ADDRESS: _________________________________________________
SPONSOR/FIRM INFORMATION
SPONSOR NAME ___________________________________ LICENSE NO. ___________________
D/B/A (IF APPLICABLE) ______________________________________________________________
MAILING ADDRESS _________________________________________________________________
CITY, STATE, ZIP CODE _____________________________________________________________
TELEPHONE NUMBER ( _ _ _ ) _ _ _ - _ _ _ _
I/We certify that the Student Leasing Agent Applicant is at least 18 years of age, has not been a Student Leasing Agent
permit holder or a Leasing Agent licensee within the past 2 years, and has a high school diploma or an equivalent course of
study (i.e., GED). I/We further certify that the Student Leasing Agent Applicant shall be subject to the standards of
practice and disciplinary provisions of a Leasing Agent licensee and the Managing Broker shall be responsible for the
activities and actions of the Student Leasing Agent as if the Student Leasing Agent was a Leasing Agent licensee.
_____________________________________
_______________________________
Student Leasing Agent Signature
Managing Broker Signature
_____________________________________
_______________________________
Date
Managing Broker License No.
$25 Fee Payable to the Illinois Department of Financial and Professional Regulation is required with this Form.
320 WEST WASHINGTON STREET SPRINGFIELD, ILLINOIS 62786 PHONE: 800-560-6420 FAX: 217-782-3390 TTY: 866-325-4949
http://www.idfpr.com
IL 505-0362 (Revised 1/16)