Propane Gas Fitters Original Certificate, Initial Application

License Description/Selection:

Providing Propane Gas Services means to install, repair, service, and replace propane gas piping, propane gas utilization equipment, and associated accessories.

I am applying for a Propane Gas Fitter Certificate under:

Option 1: I hold a current certificate of completion of the National Propane Gas Association Certified Training Program for Distribution Systems Operations.

Option 2: I hold a gas fitters license from a county or municipal corporation AUTHORIZING THE INDIVIDUAL TO PROVIDE PROPANE GAS SERVICES under a licensing program that is in existence prior to July 1, 1995 and that is acceptable to the Board

Option 3: I am able to demonstrate qualifications that are satisfactory to the Board and that are at least equivalent to the qualifications required by the National Propane Gas Association Certified Training Program for Distribution Systems Operation.

Personal Information:

Name:

(First)

(Middle)

(Last)

Mailing Address:
City, State, Zip:	, -
County:

Social Security Number:
Date of Birth:	- -

Place of Birth:

	I was born in the United States
	City and State: ,
	I was born outside the United States
	City and Country:

Daytime Phone Number:	- -
Fax Number:	- -
Personal E-mail Address:
Business E-mail Address:	(Optional)

You may, if you so choose, use the same email address in both fields presently designated for �Business Email Address� and �Personal Email Address�. However, please note that your business address may be released upon the request from a third party. Your personal email address will only be used for the purposes of communications from LABOR. In addition, if you wish to omit your business email address from the lists of licensees that from time-to-time LABOR makes available to third parties, you must notify us in writing or you can opt out by leaving your business email address blank. You may send your Opt-out notice to dlopl-labor@maryland.gov

Required Information:

Have you ever:

1.	Been convicted of a felony or misdemeanor in any State or Federal Court?	Yes	No
2.	Had this type of license, certificate, registration, or permit denied, suspended, or revoked by Maryland or any other jurisdiction?	Yes	No

Certification:

By pressing "Submit" below:

In accordance with Executive Order 01.901.1983-18, the Department of Labor is required to advise you as follows regarding the collecting of personal information: Personal information requested by the licensing agency of the Department is necessary in determining your eligibility for licensure. Such personal information is also intended for use as an additional means of verifying the licensee�s identity or to enable the agency to communicate, in a timely manner, with the licensee should the need arise. The licensee has a right to inspect his/her personal record and to amend or correct the personal data if necessary. Personal information is generally available for inspection by the public only in accordance with the Public Information Act. Personal information is not routinely shared with state, federal or local government agencies.

[ Home ] [ What's New! ] [ General Info ] [ LABOR Divisions ] [ Forms & Applications ] [ Search The Site ]