Maryland Department of Labor
REPORT UNLICENSED HOME IMPROVEMENT ACTIVITY
|[pic] | |DO NOT WRITE IN THIS SPACE |
| |STATE OF MARYLAND |OFFICE RECORD |
| |DEPARTMENT OF LABOR | |
| |DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING |DATE RECEIVED_______________________ |
| |MARYLAND HOME IMPROVEMENT COMMISSION | |
| |500 N. CALVERT STREET 410-230-6309 BALTIMORE, MARYLAND 21202-3651 |COMPLAINT NUMBER___________________ |
Instructions: This form is only for reporting an unlicensed individual acting as a home improvement contractor or salesperson. If you have filed a separate complaint or plan to file a complaint against a person with whom you have done business, you do not need to complete this form. Only complete this form if you want to report an individual who does not hold a MHIC license while working on someone else’s property; advertising to provide home improvement services, or driving a vehicle that advertises home improvement services and does not have a MHIC license number displayed.
A. If you are reporting an individual who appeared to be unlicensed providing home improvement services in Maryland, complete Sections 1 and 2.
B. If you are reporting a home improvement advertisement that did not display a MHIC number, complete section 3.
C. If you are reporting a vehicle advertising home improvement services without a MHIC number, complete section 4.
D. Complete section 5 with your name and contact information.
This form is for reporting unlicensed home improvement activity. If you are a homeowner who has paid money to, or have done business with, an unlicensed individual, or if you wish to file a complaint against a licensed home improvement salesperson, or contractor, you may download or request a complaint form from the Commission by calling 410-230-6309. This form is only for reporting an unlicensed individual whom you believe is advertising or providing home improvement services in Maryland without a proper license issued by MHIC.
To check the licensing status of an individual or business, please go to labor.license/mhic
and click on “License Search”
1. Name and Contact Information of the Individual or Business You are Reporting
|Full Name | |
|Home Address | |
|Business Name | |
|Business Address | |
|Telephone Number(s) | |
|Email Address | |
|Vehicle Tag (State & No.) | |
|Vehicle Make & Model | |
2. Location of Work Performed
|Job Site Address | |
|Job Site Telephone No. | |
|Category of Work (circle one) | Contractor Salesperson |
|Job Status (circle one) |Not Yet Started In Progress Completed Unknown |
|Nature of Work (describe work performed | |
|and dates of work) | |
| | |
| | |
3. Advertisement for Home Improvement Services
|Name of Publication | |
|Type of Publication | Flyer Internet Mailing Magazine Newspaper |
| | Radio Sign TV Other __________________ |
| Date of Publication | |
| Address: | |
|Attach a copy of the advertisement and | |
|provide | |
|any other information. | |
| | |
| | |
4. Vehicle Displaying Home Improvement Services Without Displaying A MHIC Number
|Date & Time Vehicle Spotted | |
| | |
| | |
|Spotted | |
|Exact Location of Vehicle | |
|Vehicle Make & Model | |
|Vehicle Color | |
|Vehicle Tag (State & No.) | |
|Attach a clear photo of the vehicle’s | |
|lettering or write the exact words | |
|displayed on the vehicle | |
| | |
| | |
| | |
| | |
| | |
| | |
5. Your Name and Contact Information (Optional)
|Full Name | |
|Home Address | |
|Telephone Number | |
|Email Address | |
|Relationship to the person being reported | |
|(if any) | |
| | |
|Today’s Date | |
REVISED: NOVEMBER 2016
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