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LIC38 Electrical License Application - New York City

08/14 LIC38 : Electrical License Application Application must be typewritten. 4 Applicant Information Required for all applications. (*Indicates optional.) First name Middle Initial Last name Home address Home telephone city State Zip * mobile telephone Date of Birth (m/d/y) Social Security No. E-Mail Original Renewal Reissue Change Master Special 2 License Type 1 Application Type 3 License Number 5 Responsible Representative (Note: There can be ONLY ONE Responsible Representative) Are you the Responsible Representative for the business?

Middle Initial. Last Name. Home Address. Home Telephone. City. State: Zip *Mobile Telephone. Date of Birth (m/d/y) Social Security No. E-Mail. Original

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  York, Name, Mobile, Telephone, New york city, City, Address, Mobile telephone

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