Have you ever had a real estate or other professional license, certification or similar credential revoked, suspended, surrendered in lieu of formal prosecution, or denied in New Jersey or any other state?

$($A copy of the document $($Order$,$ consent agreement, etc.$)$ imposing a suspension or revocation of a professional license you previously held is required.$)$

A$.$ Yes

B$.$ No

yright $($C$)2024.$ PSI. All rights reserved.

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U$.$S$.,$ Ca$.+18558287189$

Intl. $+16175649052$

$($x$)$

$48$

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