Transcription of REQUEST FOR DUPLICATE LICENSE - michigan.gov
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REQUEST FOR DUPLICATE LICENSE - michigan.gov
Bureau of Professional Li censing PO B ox 30670 Lansing, MI 48909 Telephone: ( 517) 241-9288 REQUEST FOR DUPLICATE LICENSE Authority: 1979 PA 152 Name on LICENSE Permanent ID # Reason for replacement: Lost Stolen Destroyed Telephone number E-mail address _____ _____ Signature Date FEE PAYMENT INFORMATION - CHECK ALL THAT APPLY ($ PER REQUEST ) Accountancy - Individual Accountancy - Firm Appraiser, Real Estate Appraisal Management Companies Architect Collection Practices - Individual Collection Practices - Firm Heari ng Ai d Dealer/Salesperson/Trainee Landscape Architect Personnel Agency - Type A Personnel Agency - Type B Personnel Agency AgentProfessional Engineer Professional Surveyor Real Estate - Salesperson Real Estate - Associate Broker Real Estate - Branch Office Real Estate - Individual Broker Real Estate - Broker Company1101-90 1102-90 1201-90 1202-90 1301-90 2401-90 2402-90 3501-90 3901-90 6101-90 6105-90 6106-90 6201-90 4001-90 6501-90 6502-90 6503-90 6504-90 6505-90 DUPLICATE LICENSE requests for the Cosmetology and Barber Professions please vis
fees are authorized by the state license fee act, 1979 pa 15, and are
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