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New Occupational and Professional License Application
First Name
Responsible Party First Name is Required.
Last Name
Responsible Party Last Name is Required.
Phone Number
Phone Number is Required.
Email Address
Please provide the correct email address.
Please select your discipline below.
Accountancy
Architecture, Interior Design & Landscape Architects
Barber & Cosmetology
Combat Sports
Funeral Directors
Industrial Trades
Professional Engineer
Real Estate Appraisers
Real Estate Commission
Security
Tour Guide
Which type of license?
Choose Type of License
Upload One 2"x2" passport style photo (jpeg format)
Choose file...
Upload Government-issued identification (e.g., driver’s license)
Choose file...
Company Website
Company Website is Required.
Have you ever had an occupational or professional license revoked or suspended in any jurisdiction?
No
Yes
Upload an occupational or professional license revoked or suspended in any jurisdiction documents
Choose file...
Are you applying for license by Endorsement?
No
Yes
Upload proof of Completion Certificate
Choose file...
Are you applying for license by Endorsement?
No
Yes
Upload copy of transcript
and
copy of State License
Choose file...
Upload the Employment Verification Letter
or
Enrollment in Apprenticeship Program
Choose file...
Number of Years Experience.
Number of years Experience is Required.
Are you applying Journeyman By Exam or By Waiver?
Exam
Waiver
Upload W2s/1099s/Tax Records
and
Employment Verification Letter
and
NEC Code Class Certificate.
Choose file...
Upload Certificate of Completion
or
Formal Designation Certificate
or
Transcripts.
Choose file...
Upload W2s/1099s/Tax Records
and
Employment Verification Letter
and
NEC Code Class Certificate.
Choose file...
Date of Birth
Date of Birth is Required.
Social Security Number
Social Security Number is Required.
Are you affiliated or have you ever been affiliated with any organization to overthrow the government of the United States or any government entity foreign or domestic?
No
Yes
upload proof of corporate registration
Choose file...
Agency Name
Agency Name is Required.
Agency License Number
Agency License Number is Required.
Upload Official Employment Letter from New Agency
Choose file...
Do you work for District of Columbia Public Schools (DCPS)?
No
Yes
Upload DCPS Designation Letter
Choose file...
Are you armed?
No
Yes
Upload Armed Range Certificate
Choose file...
Date of Fingerprinting
Date of Fingerprint is Required.
Upload Fingerprint Results
Choose file...
Do you understand that you must report any arrests within (2) two business days from the arrest and present any documents relating to the arrest to an official or detective at SOMB. If you do not comply with the legislation DCMR Title 17, Chapter 21 Section 2105.3 your commissioned license will be revoked and will no longer be permitted to work in the private security industry in the District of Columbia. I read and understand this statement.
Yes
I certify that all documents and information that I have provided regarding my arrest history to be true and correct. I understand the making for false statements is punishable by criminal penalties as listed: D.C. Code, Section 22-2405 states in part “A person who commits the offense of making false statements, if that person willfully makes a false statement that is in fact material, in writing, directly or indirectly, to any instrumentality of the District of Columbia government, under circumstances in which the statement could reasonably be expected to be relied upon as true; provided, that the writing indicates that the making of a false statement is punishable by criminal penalties” D.C. Code, Section 22-2404 states “A person commits the offense of false swearing if under oath or affirmation he or she willfully makes a false statement, in writing, that is in fact material and the statement is one which is required by law to be sworn or affirmed before a notary public or other person authorized to administer oaths.” Violations of these two statutes can result in your application being disapproved.
Yes
Affiliated Agency
Affiliated Agency Name is Required.
What type of broker?
Principal Broker
Associate Broker
Brokerage Name
Brokerage Name is Required.
Have you been convicted for a crime (other than minor traffic violations)?
No
Yes
Provide a description of the charges of convicted for a crime
Upload the associated court documents (Criminal History searches are not accepted in lieu of official court disposition.)
Choose file...
Do you owe any outstanding debt over $100 to the District government as a result of any fine, fee, penalty, interest, or past due taxes as stipulated in the "Clean Hands Before Receiving a License or Permit Act of 1996" (DC Law 11-118, DC Code §47-2861 et seq.)?
No
Yes
Upload proof of compliance with the DC Office of Tax and Revenue.
Choose file...
Do you owe any outstanding debt to the District government as a result of any past due child support payments as stipulated in the “Child Support and Welfare Reform Compliance Amendment Act of 2000“ (DC Law 13-269, DC Code §46-225.01)?
No
Yes
Upload proof of compliance with the DC Office of Tax and Revenue.
Choose file...
I certify that the above statements on this application are true and complete to the best knowledge and belief. I agree to comply with all applicable laws and regulations of the District of Columbia. I/We understand that, anyone who makes a false statement on this form can be criminally prosecuted; and, if convicted, fined up to $1000, imprisoned up to 180 days, or both, under D.C. Official Code § 22-2405.
Sign Here
Full Name
Email Address
Please provide correct email address.
Date/Time
I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.
All Input Fields Required