Application For An Expired Texas Cosmetology License Page 2

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STATEMENT OF APPLICANT
I certify that I will comply with all applicable provisions of the Tex. Occ. Code, Chapters 51, 1602, and 1603; 16 Tex. Admin.
Code, Chapter 60; and, the Cosmetology Administrative Rules, 16 Tex. Admin. Code, Chapter 83. I understand that providing
false information on this application may result in denial or revocation of the license I am requesting and the imposition of
administrative penalties.
Date Signed
Signature of Applicant
NOTE:
State law prohibits renewing a license more than once after a licensee has defaulted on a student loan guaranteed by the Texas
Guaranteed Student Loan Corporation (TGSLC) unless the licensee has entered into a repayment agreement with TGSLC. YOU
SHOULD CONTACT TGSLC BEFORE FILING THIS APPLICATION if you have defaulted on a student loan. An application or renewal may be
rejected if this agency has received information from TGSLC that the applicant has defaulted on a student loan. The Texas Guaranteed
Student Loan Corporation can be contacted at: Texas Guaranteed Student Loan Corporation, P.O. Box 15996, Austin, Texas
78761-5996, Telephone: 1-800-222-6297.
All payments must be in the form of a cashiers check or money order
and payable to TDLR.
TDLR Form Cos rev 07/2013
This document is available on the TDLR website at

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