NEBRASKA REAL ESTATE EXAMINATION 
SALESPERSON RETAKE APPLICATION
RETAKE EXAMINATION FEE: $150.00
For Commission Use Only

____________________
Receipt#

FEES ARE NOT REFUNDABLE

INSTRUCTIONS:

1. This application must be submitted to the Real Estate Commission office with the appropriate examination fee.

2. NOTE: If your original or updated application is more than one year old, a new original application, including a photo and full application fee, will be needed.

Please mark the portion of the exam you need to retake:

You will only be allowed access to the portion of the examination indicated by our records and in compliance with the license regulation. If our records do not agree with the portion you indicated, above, we will attempt to contact you so that you may prepare appropriately. Please provide a telephone number and email address where you can be reached.

Name

Last First Middle Soc. Sec. #

Residence Address           
  
                             Street Number - Mailing Address                                            City

County State Zip Telephone No.


(Date of Birth)

I hereby make application to retake the Nebraska Real Estate Salesperson Examination. I have taken the examination at a prior time and have been notified that I failed to receive a passing grade.

Submission of this Salesperson Retake Application verifies that all statements and information provided herein are true and correct and may be used as necessary by the Nebraska Real Estate Commission if furtherance of assuring compliance with the laws it regulates.

             
Applicant's Name                                                               Dated

Credit Card Information
Visa, Discover or MasterCard
Reminder - FEES ARE NOT REFUNDABLE
(Please note: Debit cards are not accepted)
Name:
Address 1:
Address 2:
City: State: Zip:
Card Number:
Expiration Date
(MM/YYYY):
Credit Card CVV Number
3 digit number on the back of the card:

All personal and financial information is safe on our secure servers.