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Get Broker Reinstatement Form - 2014 - Illinois Department Of ...

T APPLICATION AND INSTRUCTIONS READ INSTRUCTIONS BEFORE COMPLETING THIS FORM 1. Complete and print page 2 of this document and MAIL with correct fee to the above address. THIS FORM CANNOT BE SUBMITTED ELECTRONICALLY. Renewal fee: $200 2. Payment must be in the form of a check or money order made payable to the Illinois Department of Financial and Professional Regulation. FEES ARE NOT REFUNDABLE. After reading the following instructions, if you have any questions call 800/560-6420. 3. Please.

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