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                            THE  TATE S
                            of 
                                                          Department of Commerce, Community, and Economic Development 
                                                          Division of Corporations, Business and Professional Licensing                
                               ALASKA                           
                                                    Construction Contractors Program 
                                                    PO Box 110806, Juneau, AK 99811 
                                                          Phone: (907) 465-2050 
                                           Email: ConstructionContractors@Alaska.Gov 
                                Website: ProfessionalLicense.Alaska.Gov/ConstructionContractors 
       
 General Contractor with Residential Endorsement Application Instructions 
  
 Please note:   A Residential Contractor Endorsement is an additional requirement to hold a General Contractor with Residential 
 Endorsement registration.  Submit a Residential Contractor Endorsement application (#08-4161) or a Reassignment of Residential 
 Endorsement application (#08-4464). 
  
 The following must be received by the division before your application for General Contractor with Residential 
 Endorsement can be reviewed:  
        
 1.      APPLICATION 
         A completed application, signed and notarized (#08-4819, pages 1-4), including:  
         a.    Doing Business As (DBA) name; 
         b.    For Corporations or LLCs: Name and  entity  number  registered  with  the  Corporations section of the  Division.   Your 
               business  entity  must  be  registered  with  the  Corporations  Division  before  your  General  Contractor  with  Residential 
               Endorsement application will be processed.  For information concerning these requirements, contact the Corporations 
               section at   Corporations.Alaska.Gov 
         c.    Name of all owners and principal officers or principal members. 
  
 2.      FEES 
         Fees made payable to “State of Alaska.” 
         Nonrefundable Application Fee:           $100.00 
         Registration Fee:                        $250.00 
         Total Fees Due:                          $350.00 
  
 3.      INSURANCE 
         Proof of current general liability insurance is required for registration (not less than $20,000 for damage to property, $50,000 for 
         injury, including death, to any one person, and $100,000 for injury, including death, to more than one person). 
         a.    The Certificate of Insurance Coverage form (#08-4819a) included with this packet or a certificate issued by your provider 
               may be accepted. 
        
 4.      WORKERS’ COMPENSATION 
         If your business uses employee labor or your business is a Corporation or LLC, proof of workers’ compensation insurance is 
         required  for  registration.    The  Workers’  Compensation  Worksheet  (#08-4819c)  may  be  used  to  determine  the  appropriate 
         workers’ compensation coverage required. 
         a.    A completed Workers’ Compensation Worksheet (#08-4819c) is required to be submitted with the application; 
               AND 
         b.    A certificate from a workers’ compensation insurance carrier authorized by the Alaska Division or Insurance to transact 
               business in Alaska is required to be included with the application. 
  
 5.      BONDING 
         A bond of $20,000.00 is required.  One of the following must be submitted with the application for registration: 
         a.    Surety Bond.   Issued by an insurer or other surety company using the Construction Contractor Surety Bond form (#08-
               4819b) with the bonding company’s power of attorney included with it.  The bond form must be signed by both the 
               principal (construction contractor) and the surety (bond provider);  
               OR 
         b.    Cashier’s Check. For a cash deposit to the State of Alaska to be held in a trust account established by the state.  
               OR 
         c.    Time Certificate of Deposit or Savings Passbook. Issued by a bank or trust company authorized to do business in Alaska.  
               The certificate or passbook must read “State of Alaska in trust for (contractor name)”.  The original certificate or passbook 
               will be held by the State.  
 08-4819 (Rev. 03/04/2022)                                              Application Instructions                                                   Page 1 of 1 



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 General Information 
                                  
APPLICATION PROCESSING: 
The average time to process a paper application varies by program but can take several weeks from the date it is received in this office 
complete with all correct forms, supporting documents and appropriate fees paid. When the application is complete and correct, and 
all supporting documents have been received and all fees have been paid, the license will be issued and sent to you. Start the process 
far enough in advance to allow for processing time. Applications are reviewed in order of receipt in our office, and walk-in customers 
should not expect immediate review.  
 
LICENSE TERM:  
There is no “inactive” status. If you choose not to renew your license, it will lapse. Licenses are issued for a two-year period and expire 
on September 30 of even-numbered years, regardless of the date of issuance, except licenses issued within 90 days of the expiration 
date are issued to the next biennial expiration date. One renewal notice will be mailed at least 30 days before license expiration to 
the last known address of record. 
 
PROFESSIONAL FITNESS QUESTIONS: 
A “yes” response in the application does not mean your application will be denied. If you have responded “yes” to any professional 
fitness questions in the application, be sure to submit a signed and dated explanation, and the charging document and judgement. 
 
DENIAL OF APPLICATION: 
Please be aware that the denial of an application of licensure may be reported to any person, professional licensing board, federal, 
state, or local governmental agency, or other entity making a relevant inquiry or as may be required by law. 
 
RANDOM AUDIT: 
If your program requires continuing education, the Division will audit a percentage of the license renewals. If your license is randomly 
selected for audit, a letter will be sent with instructions to submit documentation as proof you satisfied the continuing competency 
requirements as stated on this renewal form.  Licensees are randomly selected by computer and may be randomly selected as often 
as the computer program chooses. You must save your documents for at least four years so you can respond to audits. 
 
ADDRESS OR NAME CHANGE: 
In accordance with 12 AAC 02.900, it is the applicant's/licensee's responsibility to notify the Division, in writing, of changes of address 
or name. Name and address change notification forms are available on the Division’s website. The address of record with the division 
will be used to send renewals and all other official notifications and correspondence. The name appearing on the license must be your 
current legal name. 
 
CERTIFIED TRUE COPIES:   
If any of the required documents will be issued under a former name, indicate on the application and submit marriage license and/or 
court documents that are notarized as a “certified true copy of the original document”. To obtain a certified true copy, you must 
present the notary with the original document along with the photocopy. You must write, “I certify this is a true copy of the original 
document” and sign your name. The notary will compare the original document with the copy and then notarize your signature. 
 
SOCIAL SECURITY NUMBERS: 
AS 08.01.060 and 08.01.100 require that a U.S. Social Security Number be on file with the division before a professional license is 
issued or renewed for an individual. If you do not have a U.S. Social Security Number, please complete the Request for Exemption 
from Social Security Number Requirement form (#08-4372) located at ProfessionalLicense.Alaska.Gov or contact the division for a 
 copy of the form. This form is required with every application if you do not have a U.S. Social Security Number. 
PUBLIC INFORMATION: 
Please be aware that all information on the application form will be available to the public, unless required to be kept confidential by 
state  or  federal  law.  Information  about  current  licensees,  including  mailing  addresses,  is  available  on  the  division’s  website  at 
ProfessionalLicense.Alaska.Gov under License Search. 
 
ABANDONED APPLICATIONS:  
Under 12 AAC 02.910, an application is considered abandoned when 12 months have elapsed since correspondence was last received 
from or on behalf of the applicant. An abandoned application is denied without prejudice. At the time of abandonment, the division 
will send notification to the last known address of the applicant, who has 30 days to submit a written request for a refund of biennial 
license and other fees paid. The application fee will not be refunded. If no request for refund is received within that timeframe, no 
refund will be issued, and all fees will be forfeited. 
 
BUSINESS LICENSES: 
The status of a professional license will directly impact the status of an associated business license. Renewal applications for business 
licenses are mailed separately. For more information about business licenses, (907) 465-2550 or BusinessLicense.Alaska.Gov 
 
08-4819 (Rev. 03/04/2022)                                     General Information                                           Page 1 of 2 



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STALE DOCUMENTS: 
Application forms, authorizations and verifications older than 12 months from the date the document was received by the division 
will be considered stale; the document must be resubmitted as appropriate before the application will be considered by the division 
or a licensing board. Application documents include the application documents and verifications of licensure from other licensing 
jurisdictions. (12 AAC 02.915) 
 
PAYMENT OF CHILD SUPPORT:  
If  the Alaska Child Support  Enforcement  Division  has determined  that you are in  arrears on  child support, you  may be  issued  a 
nonrenewable temporary license valid for 150 days. Contact Child Support Services at (907) 269-6900 to resolve payment issues. 
 
STATUTES AND REGULATIONS: 
The complete set of statutes and regulations for this program are available by written request or online at the division’s website: 
ProfessionalLicense.Alaska.Gov 
 
If you would like to receive notice of all proposed regulation changes for your program, please send a request in writing with your 
name, preferred contact method (mail or email), and the specific program you want to be updated on to the address below. 
      
                                                Regulations Specialist 
                                         Department of Commerce, Community, and Economic Development 
                                         Division of Corporations, Business and Professional Licensing 
                                         EMAIL: RegulationsAndPublicComment@Alaska.Gov 
  
08-4819 (Rev. 03/04/2022)                                     General Information                                                  Page 2 of 2 



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                   THE  TATE S                                                                                          CON 
                     of                                                                                     FOR DIVISION USE ONLY 
 
                       ALASKA 
                     Department of Commerce, Community, and Economic Development                                       
                     Division of Corporations, Business and Professional Licensing 
                       
        Construction Contractors Program 
        PO Box 110806, Juneau, AK 99811 
        Phone: (907) 465-2050 
        Email: ConstructionContractors@Alaska.Gov                   
        Website: ProfessionalLicense.Alaska.Gov/ConstructionContractors 
 
General Contractor with Residential Endorsement Application  
 
   PART I        Application Type 

  Application Type:        New Application                          Owner/Entity Change 

   PART II       Payment of Fees 
                           Nonrefundable Application Fee                                                               $100.00 
  Required Fees:  
                           License Fee                                                                                 $250.00 
 
   PART III       Registration Information 
  Doing Business As: 
                          
  (DBA) 
                                 P.O. Box or  Street                                                                   City                                                   State                                            Zip 
  Mailing Address: 

  Contact Phone:         
  EMAIL AGREEMENT: By choosing to receive correspondence on any matter affecting my license or other business with the Alaska Division of Corporations, Business 
  and Professional Licensing, I agree to maintain an accurate email address through the MY LICENSE web page. I understand that failure to check my email account or 
  to keep the email address in good standing may result in an inability to receive crucial information, potentially resulting in my inability to obtain or maintain licensure. 
  Email Address:                                                                          Select One:      Send my Correspondence by Email 
                                                                                                           Send my Correspondence by Mail 
   Corporation, LLC, LP or LLP 
  Are you a Corporation, LLC, LP or LLP?  
  Reminder: If you are a corporation or LLC your business entity must be registered with  Yes           No 
  the Corporations Division before this application is processed. 
   
                                                                   IF YES, provide: 
  Name of Alaska                                                                              Alaska Entity 
                                                                                                                        
  Corporation or LLC:                                                                         Number:  
   Owner or Entity Name Changes 

  Are you changing the Owner or Entity name on an existing license?                       Yes           No 

                                                                    IF YES, provide: 

   License Number:                                                                        
  
08-4819 (Rev. 03/04/2022)                              General Contractor with Residential Endorsement - Application             Page 1 of 4 



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       PART IV  Ownership Information 
      Check the applicable box and provide the complete name(s) of the owner(s) including all partners, corporate officers, or managing 
      members, whichever is appropriate; and provide U.S. Social Security Numbers and birthdates for sole proprietor or partners.  AS 
      08.01.060 requires you to provide your United States Social Security Number. It is considered confidential information and will not 
      be publicly disclosed; it may be used to verify inter-state licensure. 

              Sole Proprietorship   Partnership                                Corporation                              LLC 

                                                                                  Social Security Number                    Date of Birth 
              Full Name                                  Address                                 (Sole Proprietorship/   (Sole Proprietorship/ 
                                                                                                 Partners Only)             Partners Only) 

       PART V   Insurance 
      Provide proof of current general liability insurance to register pursuant to AS 08.18.101. 
              I have completed the attached Certificate of Insurance Coverage form (#08-4819a) or attached a certificate issued by 
              my  provider  to  this  application  as  proof  of  public  liability  and  property  damage  insurance  covering  contracting 
              operations in this state in the sum of not less than $20,000 for damage to property, $50,000 for injury, including death, 
              to any one person, and $100,000 for injury, including death, to more than one person.  
                
       PART VI  Workers’ Compensation 
      I have completed the Workers’ Compensation Worksheet 
      (#08-4819c) and included it with this application.                      Yes                 No 

      Is the documentation/certificate showing workers’ 
      compensation included in this application?                              Yes                 No 

      If No, please state the reason (i.e., sole proprietor with no 
                                                                     
      employees, etc.):  
 
08-4819 (Rev. 03/04/2022)                              General Contractor with Residential Endorsement - Application                Page 2 of 4 



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         PART VII     Bonding 

        A bond of $20,000.00 is required pursuant to AS 08.18.071.  

        Please check the appropriate box below:  
              
              I have provided original documentation or a copy of my surety bond (#08-4819b). 
               
        -or- 
              I have provided an original Time Certificate of Deposit or Savings Passbook issued by a bank or trust company authorized 
               to do business in Alaska.  The certificate or passbook must read “State of Alaska in Trust for (contractor name).” 
        -or- 
              I have provided a cashier’s check for a cash deposit to the State of Alaska to be held in a trust account established by 
              the state. 
         
        PART VIII     Residential Contractor Endorsement 
        Residential Endorsement 
                                  
        Holder Name:  
        Residential Endorsement  
        Holder License Number:  
 
08-4819 (Rev. 03/04/2022)                              General Contractor with Residential Endorsement - Application             Page 3 of 4 



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                THE  TATE S                                                                                             CON 
                of                                                                                FOR DIVISION USE ONLY 
 
                    ALASKA 
                Department of Commerce, Community, and Economic Development                                             
                Division of Corporations, Business and Professional Licensing 
                  
       Construction Contractors Program 
       PO Box 110806, Juneau, AK 99811 
       Phone: (907) 465-2050 
       Email: ConstructionContractors@Alaska.Gov  
       Website: ProfessionalLicense.Alaska.Gov/ConstructionContractors 
 
Notary Signature Page  

      PART IX  Notarized Signature 

      I hereby certify that I am the person herein named and subscribing to this application and that I have read the complete 
      application, and I know the full content thereof. I declare that all of the information contained herein, and evidence or 
      other documents submitted herewith are true and correct. 
       
      I understand that any falsification or misrepresentation of any item or response in this application, or any attachment 
      hereto, or falsification or misrepresentation of documents to support this application, is sufficient grounds for denying, 
      revoking, or otherwise disciplining a license or permit to practice in the state of Alaska. 
       
      I further understand that it is a Class A misdemeanor under Alaska Statute 11.56.210 to falsify an application and commit 
       the crime of unsworn falsification. 
      A  person  who  makes  a  false  statement  on  this  application  may  be  subject  to  civil  and  criminal  penalties,  including 
      prosecution for perjury (AS 11.56.200 & AS 11.56.230). 

                     Owner, Corporate Officer, 
                                                              
       Notary Stamp  or Member Name:  

                     Owner, Corporate Officer, 
                                                              
                     or Member Signature:  

                     Notary Public for                                 Subscribed and Sworn to                         
                                            
                     State of:                                         Before me on this Day: 
                                                                              My Commission 
                     Notary Signature:                                                                                 
                                                                              Expires: 
 
08-4819 (Rev. 03/04/2022)                              General Contractor with Residential Endorsement - Application              Page 4 of 4 



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                              THE  TATE S
                              of 
                                                               Department of Commerce, Community, and Economic Development 
                                                               Division of Corporations, Business and Professional Licensing                
                                     ALASKA                     
                                                Construction Contractors Program 
                                                PO Box 110806, Juneau, AK 99811 
                                                               Phone: (907) 465-2050 
                                                Email: ConstructionContractors@Alaska.Gov 
                                       Website: ProfessionalLicense.Alaska.Gov/ConstructionContractors 
          
 Certificate of Insurance Coverage 

 Submit this completed original form   a Certificate of Insurance issued by your provider with the General Contractor application.or                                                                                                     
  
           PART I         Insurance Information  
          Corporation, Sole Proprietor 
                                         
          or All Partners’ Name(s):  

          Doing Business As (DBA):       

          Policy Number(s):   

          Amount Insured: 
                              
          (Per AS 08.18.101) 
          Effective Date:                                       Effective Date: 
                                                                                      
          (Start)                                               (End) 

           PART II        Signature 

          By the signature below we hereby certify that we are a duly authorized casualty insurer eligible to write business in the State of 
          Alaska and have written a public liability policy of not less than the limits required under AS 08.18 on behalf of the Corporation, 
          Sole Proprietor or Partners/DBA named above for registration as a Construction Contractor under the policy information listed 
          above. 
           
          In the event the above policy is cancelled for any reason, we agree to furnish the Department of Commerce, Community, and 
          Economic Development, Construction Contractors Section, at the above address, a NOTIFICATION OF CANCELLATION at least 30 
          days before the effective date of that cancellation. 

          Name of Insurance Carrier: 
                                        
          (Not Agency) 
                                      P.O. Box or  Street                                                                   City                                                   State                                            Zip 
          Address:  

          Signature of 
                                                                                      Date Signed:             
          Authorized Agent:  
  
 08-4819a (Rev. 03/04/2022)                                                Certificate of Insurance Coverage                                             Page 1 of 1 



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                      THE  TATES
                      of 
                                              Department of Commerce, Community, and Economic Development 
                                              Division of Corporations, Business and Professional Licensing                
                           ALASKA 
                                              Construction Contractors Program 
                                              PO Box 110806, Juneau, AK 99811 
                                              Phone: (907) 465-2050 
                                    Email: ConstructionContractors@Alaska.Gov 
                           Website: ProfessionalLicense.Alaska.Gov/ConstructionContractors 

Surety Bond 
(Required by Construction Contractor Statute AS 08.18.07) 

Principal Name: 
                                                                                      Title: 
(Applicant) 

DBA Name: 
                                                                          mm/dd/yyyy                     mm/dd/yyyy 
                                              Effective                               Expiration 
Bond Number:                                  Date:                                   Date: 

KNOW ALL MEN BY THESE PRESENTS that we, the above-named construction contractor, as principal, and the agency named below, as 
surety, are held firmly bound to the State of Alaska, in the sum of TWENTY THOUSAND DOLLARS ($20,000) lawful money of the United 
States, for the payment of which, well and truly to be made, we and each of us, bind ourselves, our heirs, executors, administrators, 
successors and assigns, jointly and severally, firmly by these presents.  
THE CONDITIONS OF THE ABOVE OBLIGATIONS ARE SUCH THAT: Whereas, the above bound principal has applied to, or is about to obtain 
from,  the  State of  Alaska  for registration  as  a  Residential  Contractor pursuant to  AS  08.18.011  and the  acts  amendatory thereof  and 
supplemental thereto: 
NOW THEREFORE, if the State of Alaska shall register the above bounden principal as a Residential Contractor and that principal shall 
faithfully and honestly act a Residential Contractor in accordance with law, and fully complies with the provisions of AS 08.18.071 of the 
State of Alaska and acts thereof and supplemental thereto, and if the principal shall fully indemnify and save harmless from loss the State 
of Alaska and any person who may have cause of action against the principal for any malfeasance or misfeasance in the conduct of a 
Residential Contractor, then this obligation to be voided, otherwise to remain in full force and virtue. 
LIABILITY UNDER THIS BOND commences on the date listed above and shall be continuous until the registration license is revoked or 
otherwise terminated by the Department of Commerce, Community, and Economic Development, State of Alaska (the Department) or until 
written notice from the Surety is received by the Department provided the bond has been cancelled for lawful reasons. The bond shall apply 
to all liens and liabilities which arise during the effective period of the bond to which the bond is applicable under law, even if the judgment 
liens are foreclosed or valid liens settled after the effective period of the bond or liabilities are enforced after the effective period of the 
bond.  
IN WITNESS OF THE ABOVE, principal and surety have signed and sealed this bond on the date listed below. 

Principal Signature: 
                                                                                      Date: 
(Applicant) 
                                                                          Attorney-in-
Surety Name: 
                                                                          Fact: 

Surety Signature:                                                                     Date: 

Agency Name: 

Agency Address: 

THIS BOND IS NOT VALID UNTIL SIGNED BY BOTH PRINCIPAL AND SURETY. 
Surety's Power of Attorney must be attached.                                                             Surety’s Seal 
                                                                                                          (Required) 

08-4819b (Rev. 03/04/2022)                           Surety Bond                                                        Page 1 of 1 



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                                   THE  TATE S
                                   of 
                                                        Department of Commerce, Community, and Economic Development 
                                                        Division of Corporations, Business and Professional Licensing                
                                      ALASKA                          
                                                   Construction Contractors Program 
                                                   PO Box 110806, Juneau, AK 99811 
                                                        Phone: (907) 465-2050 
                                                  Email: ConstructionContractors@Alaska.Gov 
                                         Website: ProfessionalLicense.Alaska.Gov/ConstructionContractors 
           
 Workers’ Compensation Worksheet  
  
           Doing Business As (DBA):       

           Construction Contractor 
           License Number:                

           If your business uses employee labor, or if your business is a corporation or LLC, you must provide proof of workers compensation 
           insurance by a certificate of insurance issued by a carrier authorized by the Alaska Division of Insurance to transact business in Alaska.  
           This certificate must include the following six items: 1) name of the insured exactly as licensed, 2) the DBA, 3) name of the insurance 
           provider, 4) policy number, 5) commencement date and 6) expiration date.  

           Are you a sole proprietor or partnership with employees?                                 Yes                No 

           Are you a Limited Liability Company (LLC) or Corporation with employees?   
           Please note: There are no exemptions for family, friends, or non-residents, or for part-
           time or temporary jobs.  Do not classify workers as “independent contractors” without    Yes                No 
           calling the Alaska Workers’ Compensation Division Special Investigations Unit at (907) 
           269-4002. 
           If YES to either of the above questions, please check the appropriate box below:   

                     Sole Proprietorship                                                                                
                I am a sole proprietor and have workers compensation insurance coverage for all my employees, excluding myself as the 

                      owner, and   I have attached the necessary certificate to this application. 
                I am a sole proprietor and have workers compensation insurance coverage for all my employees including myself, and  
                I have attached the necessary certificate to this application. 
                Partnership 
              
                We are a partnership and have workers compensation insurance coverage for all employees, excluding the owners, and 
             
                we have attached the necessary certificate to this application. 
                
                We are a partnership and have workers compensation insurance coverage for all employees including the owners, and  
             
                we have attached the necessary certificate to this application. 
                Limited Liability Company (LLC) 
              
                We are an LLC and have workers compensation insurance coverage for all employees excluding any members who own 
             
                10% or greater of this company (members who own 9% or less are required to be covered by workers compensation 
                insurance), and we have attached the necessary certificate to this application. 

                Corporation 
                We are a Corporation and have workers compensation insurance coverage for all employees excluding any officers or 
             
                members who own 10% or greater of this company (officers or members who own 9% or less are required to be covered 
                by workers compensation insurance), and we have attached the necessary certificate to this application. 

 08-4819c (Rev. 03/04/2022)                             Workers’ Compensation Worksheet                                             Page 1 of 1 



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              THE STATE                                                                                                    FOR DIVISION USE ONLY 
                of 
                  ALASKA 
              Department of Commerce, Community, and Economic Development 
              Division of Corporations, Business and Professional Licensing 

        State of Alaska 
        Department of Commerce, Community, and Economic Development 
        Division of Corporations, Business and Professional Licensing 
        PO Box 110806, Juneau, AK 99811 
        Phone: (907) 465-2550 

Credit Card Payment Form 

All major credit cards are accepted. For security purposes, do not email credit card information. 
Include this credit card payment form with your application.  

Name of Applicant or Licensee:      _________________________________________________________________________________________________________________________ 

Program Type:   ________________________________________________________       License Number (if applicable):                      ________________________________ 

 I wish to make payment by credit card for the following(check all that apply):                                                                    AMOUNT    

        Application Fee:  _________________________________________________________________________________________________                __________________________ 

        License or Renewal Fee:     _________________________________________________________________________________                      __________________________ 

        Other (name change, wall certificate, fine, duplicate license, exam, etc.):        

           1. _____________________________________________________________________________________________________________________ __________________________ 

           2. _____________________________________________________________________________________________________________________        __________________________

                                                                                               TOTAL:            ___________________________ 

Name (as shown on credit card):   ________________________________________________________________________________________________________________________ 

Mailing Address:            ___________________________________________________________________________________________________________________________________________________ 

Phone Number:   ________________________________________________________      Email (optional):               _______________________________________________________ 

Signature of Credit Card Holder:              _____________________________________________________________________________________________________________________ 

 08-4438                   Rev 12/26/18                   Credit Card Payment Form (all major cards accepted) 

   CREDIT CARD INFO:  Your payment cannot be processed unless all fields are completed! 

   1.    Account Number:                                                                                      All four fields MUST 
                                                                                                                                    be completed! 
   2.    Expiration Date:
                                                                                                              This section will be 
   3.    Billing ZIP Code:
                                                                                                              destroyed after the 
   4.    Security Code:                                                                                       payment is processed. 






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