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Application For Replacing The Qualifying Individual 13A-2A - California
| Application For Replacing The Qualifying Individual Form. This is a California form and can be used in Contractors State License Board Statewide . |
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CONTRACTORS STATE LICENSE BOARD 9821 Business Park Drive, Sacramento, CA 95827 Mailing Address: P.O. Box 26000, Sacramento, CA 95826 800.321.CSLB (2752) | ZZZFVOEFDJRY | &KHFN7KH/LFHQVH)LUVWFRP STATE OF CALIFORNIA Governor Edmund G. Brown Jr. APPLICATION FOR REPLACING THE QUALIFYING INDIVIDUAL General Information Listed below is general information to assist you as you complete the attached application. Detailed instructions are provided throughout the application package. Please refer to the Contractors State License Board's (CSLB) publication %OXHSULQW IRU %HFRPLQJ D /LFHQVHG &RQWUDFWRU for more detailed information about the licensing process. To receive a copy of %OXHSULQW, please contact CSLB or visit the Guides and Pamphlets page on CSLB's website. Do not submit this General Information section with your completed application the actual application begins immediately following this section on Application Page 1 of 2 and includes the Certification of Work Experience. Before you submit your application, please review and check off the following items. Enclose the nonrefundable $75 application fee with your completed application. CSLB cannot process your application without the appropriate fee made payable to the Registrar of Contractors. Your application may be returned to you if it is insufficient or incomplete. You must provide any missing information, make corrections, and resubmit your completed application to CSLB within 90 days after the date that it was returned to you or your application will become void. You cannot reinstate a void application you must submit a new application and $75 application fee if you wish to pursue licensure. Complete the application and all accompanying forms legibly in black or dark blue ink, with a typewriter, or on CSLB's website using the form-fill feature. Forms completed in pencil will be returned to you. Please make sure that you and other appropriate individuals sign and date the forms, where applicable. Full legal names are required. You must provide the full legal name of all personnel. If an individual does not have a middle name, write "None" or "No Middle Name" in the space provided. If an individual has only an initial for his or her first or middle name, write "(Initial Only)" after the initial. Leave no space blank. If a particular question or request for information does not apply to you, write "N/A" in the blank space to indicate that the question has received your attention but that it is not applicable. Your license must be in good standing before the qualifying individual(s) can be changed. You must provide a street address for both your business and residence. P.O. Boxes are not acceptable for the street address. The terms "qualifying individual" and "qualifier" are used interchangeably. The qualifying individual is the person who meets the experience and examination requirements for the license and who is responsible for the employer's or principal's construction operations. A qualifying individual is required for every classification on every license issued by CSLB. The qualifying individual may or may not be the owner of the business. (See &DOLIRUQLD &RQWUDFWRUV /LFHQVH /DZ 5HIHUHQFH %RRN &K ; or %OXHSULQW IRU %HFRPLQJ D /LFHQVHG &RQWUDFWRU, Questions 49-53.) If you need additional copies of forms (e.g., Section 2 New Qualifying Individual Full Legal Name and Address, &HUWLILFDWLRQ RI :RUN ([SHULHQFH), please make copies of the blank forms before you begin or print additional copies from CSLB's website. Please be aware that CSLB will begin accepting applications for licensure from limited liability companies (LLC) no later than January 1, 2012. A separate application will be available on CSLB's website for LLC applicants. FINGERPRINT REQUIREMENT All applicants for licensure are required to submit a full set of fingerprints for the purpose of conducting a criminal background check. Fingerprints will be compared to the records of the California Department of Justice and the Federal Bureau of Investigation to determine whether a criminal history exists. After an application has been accepted by CSLB as complete (also known as "posted"), each individual listed on the application will be sent instructions on the process for obtaining and submitting fingerprints as required by law. For more information, please visit CSLB's website and view information under the Applicants tab. EXAMINATION ELIGIBILITY REQUIREMENTS The qualifying individual for a contractor license is required to pass the written Law and Business Examination and a specific trade examination if required, unless he or she meets the requirements for a waiver (see next page for information regarding examination waivers). 3OHDVH GHWDFK WKLV *HQHUDO ,QIRUPDWLRQ VHFWLRQ EHIRUH VXEPLWWLQJ WKH FRPSOHWHG DSSOLFDWLRQ SDFNDJH WR &6/% 13A-2a (rev. 06/11) General Information Page 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com APPLICATION FOR REPLACING THE QUALIFYING INDIVIDUAL General Information To be eligible to take an examination, the qualifying individual must have had, within the last 10 years, at least four (4) full years of experience in the classification for which he or she is applying. The experience must be at no less than a journeyman level, or as a foreman, supervisor, contractor, or owner-builder. A "journeyman" is defined as an experienced worker who is fully qualified (as opposed to a trainee, helper, laborer, assistant, apprentice, etc.) and is able to perform the trade without supervision, or a person who has completed an apprenticeship program. Experience is documented on the Certification of Work Experience form (see below). CSLB may grant up to three (3) years of credit toward the four-year requirement for completed education and/or apprenticeship programs. Education/apprenticeship is documented in Section 4 of the application. CERTIFICATION OF WORK EXPERIENCE The Certification of Work Experience form must be completed by the qualifier and certified by a person who has direct knowledge of the experience and time period listed. The experience must be verifiable through payroll records or similar documents. Corrections on the Certification forms must be initialed by the certifier. Forms containing strikeouts or modifications that may compromise the validity of the work experience certification may not be accepted. To assist the certifier in completing Part 2 of the Certification of Work Experience form, the Description of Classificati
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