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Electrical Contractor's License Application

Step 1    Applicant MUST select ONLY one option

Step 2:    Applicant MUST attach a Passport size picture to the application

Note: You will need a set of two Passport size pictures. One is to be attached with the application and the other is to be submitted with the application

Step 3:    Applicant MUST provide the complete Business Name under which the Electrical Contractor will be operating

Step 4:    Applicant MUST provide Previously used Business Name under which the Electrical Contractor was operating

Note: NOT REQUIRED if this is Applicant's First License

Step 5:    Applicant MUST provide Street Name where the Business is located

Step 6:    Applicant MUST provide City, State and five digit Zip Code of where the Business is located (If known, enter the 9-digit zip code information: for example "48206-1234")

Step 7:    Applicant MUST provide complete telephone number of the Business (10 digit phone number is REQUIRED which MUST include the area code).

Step 8:    Applicant MUST provide complete E-Mail address

Step 9:    Applicant MUST provide Full Names, Complete Addresses and Titles of ALL partners and officers if the firm is a partnership or corporation

Step 10: 
   Applicant MUST provide applicant's Full name (Last, First and Middle Initial)

Step 11:    Applicant MUST provide his/her date of birth in the MM/DD/YYYY format

Step 12:    Applicant MUST provide applicant's age

Step 13:    Applicant MUST provide applicant's Street Name

Step 14:    Applicant MUST provide applicant's Place of birth

Step 15:    Applicant MUST provide applicant's City, State and five digit Zip Code (if known, enter the 9 digit Zip Code information: for example :48206-1234")

Step 16:    Applicant MUST provide applicant's complete telephone number (10 digit phone number is REQUIRED which MUST include the area code).

Step 17:    Applicant MUST provide applicant's valid current Driver's License number

Step 18:    Applicant MUST sign and notarize by Notary Public

Step 19:
    Applicant MUST provide applicant's full name. Provide Last, First and Middle Initial

Step 20:    Applicant MUST provide applicant's date of birth in the MM/DD/YYYY format

Step 21:    Applicant MUST provide applicant's Street Address


Step 22:    Applicant MUST provide applicant's Place of birth

Step 23: 
   Applicant MUST provide applicant's City, State and five digit Zip Code (if known, enter the 9 digit Zip Code information: for example: "48206-1234")

Step 24:    Applicant MUST provide applicant's complete Telephone number (10 digit phone number is REQUIRED which MUST include the area code)

Step 25:    Applicant MUST provide applicant's valid current Driver's License number

Step 26:    Applicant MUST provide What agency issued applicant's first Master Electrician License

Step 27:    Applicant MUST provide the Year applicant was issued first Master Electrician License

Step 28:    Applicant MUST provide Where applicant's Present Master Eectrician License was issued

Step 29:    Applicant MUST provide applicant's present Master Electrician License number

Step 30:    Applicant MUST provide the Year applicant's present Master Electrician License was issued

Step 31:    Applilcant MUST provide who/where did applicant Last contract under as a Master Electrician

Step 32:    Applicant MUST provide which year applicant last contracted above as Master Electrician

Step 33:    Applicant MUST sign and notarize by Notary Public

Step 34:
    Examining Board will sign and date here

Step 35:    FOR CLERICAL USE ONLY

Step 36:    TO BE COMPLETED BY EXAMINING BOARD ONLY

Step 37:
    TO BE COMPLETED BY EXAMINING BOARD ONLY