ELECTRICIAN LICENSE RENEWAL, EFFECTIVE 10/01/2019 ALL ...

[Pages:2]ELECTRICIAN LICENSE RENEWAL, EFFECTIVE 10/01/2019 ALL STATE OF IOWA ELECTRICIAN LICENSES EXPIRE DECEMBER 31, 2019

RENEW ONLINE at

1. DO NOT SEND CASH. Make check or money order payable to the Iowa Electrical

Examining Board (IEEB).

2. Return this renewal form and fee, postmarked by December 31, 2019 to:

ELECTRICAL EXAMINING BOARD 215 E 7TH ST DES MOINES, IA 50319

3. LATE FEES are added to all renewals postmarked after December 31, 2019. A renewal form

returned to a licensee for any reason will be considered LATE if it is not re-postmarked by December 31, 2019. 4. CONTINUING EDUCATION is required to renew Master A or B, Journeyman A or B, Residential Master and Residential Electrician licenses. All Continuing Education hours must be completed by December 31, 2019. 6 hours of Iowa Board-approved Continuing Education is required for each year in which the license was held, with at least 6 hours of Continuing Education over the National Electrical Code. To verify your CEUs please go to and create a log in. Under, "My Licenses", click on your license number. 5. The licensee has until March 31, 2020 to renew, but a 10% late fee for each month or portion thereof past the December 31, 2019 expiration date will be added. After March 31, 2020, the holder of an expired license will be required to pass the state-sponsored examination to have the license re-instated.

COMPLETE, SIGN AND DATE NEXT PAGE

2020-2022 Renewal

Late Fees accrue at 10% per month when renewal is postmarked on or after:

01/01/20 02/01/20 03/01/20

0%

20%

30%

I request renewal of the license(s) indicated below: Postmarked by 12/31/2019

Electrical Contractor (Name of Business required below)

Master

Class A

Class B

$375.00 $412.50 $450.00 $487.50 $375.00 $412.50 $450.00 $487.50

Inactive Master*

Class A

Class B

$75.00

*(If you wish to continue to work as an electrician you must apply for a Journeyman License also)

Journeyman

Class A

Class B

$75.00

$82.50 $82.50

$90.00 $90.00

$97.50 $97.50

Residential Electrical Contractor (Name of Business required below) Residential Master

$375.00 $412.50 $450.00 $487.50 $375.00 $412.50 $450.00 $487.50

Residential Electrician

$75.00 $82.50 $90.00 $97.50

Special Electrician Irrigation System Wiring Sign Installation $75.00 $82.50 $90.00 $97.50

Disconnect/ Reconnect Existing Air Conditioning or Refrigeration Equipment**

**(If you hold a Master or Journeyman HVAC or Refrigeration license through the plumbing and mechanical board this license is not required)

Apprentice (One year license) Apprentice Program Name______________________ $20.00

$22.00 $24.00 $26.00

Unclassified (One year license)

$20.00 $22.00 $24.00 $26.00

APPLICABLE LICENSE FEE(S) BY CHECK OR MONEY-ORDER

MUST ACCOMPANY THIS FORM--CASH PAYMENTS WILL BE REJECTED

PLEASE TYPE OR PRINT LEGIBLY

Company Name (Electrical Contractors Only)

Insurance Expiration Date (Please make sure we have a current copy)

IWD Contractor Registration # and Expiration Date (Example: CXXXXXX)

First Name

Middle Name

Last Name

Last 4 digits of Social Security Number

Date of Birth

E-Mail Address

Address

Check here if new address City

State

County

Zip Code

Phone number Check here if new phone number

My 2017-2019 Iowa Electrical License number is:

EL

I have completed the Continuing Education requirements as established by the Board. (See #4 above) YES NO Have you entered a plea of guilty or been convicted of a felony since your last electrical license was issued to you? YES NO If yes, please explain fully. _________________________________________________________________________________ Have you been denied application or licenses as an electrician, or been disciplined and/or revoked with regard to the practice of electrical wiring in violation of this state's law, or that of any other jurisdiction since your last electrical license was issued to you?

YES NO If yes, please explain fully. ___________________________________________________________________ Provide or update your current employer: EMPLOYER NAME:_______________________________________________________________________________________ EMPLOYER ADDRESS: CITY ______________________________________________ STATE____________ ZIP___________ EMPLOYER PHONE #:_____________________________________________________________________________________ START DATE: ____________________________________________________________________________________________ JOB TITLE: ______________________________________________________________________________________________

I have been served military active duty orders while holding my 2017-2019 electrical license(s).

Signature of Applicant

Date

2020-2022 Renewal

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