Tennessee Lle (Limited Licensed Electrician) - Renewal Notice Form
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1TENNESSEE LLE (Limited Licensed Electrician) – RENEWAL NOTICE
RENEW ONLINE!
RENEW BY MAIL
State of Tennessee - LLE
Board for Licensing Contractors
Attach payment (cash or check) to this completed
500 James Robertson Parkway
Pay by credit card / Processed within 24 hrs.
renewal form. Fees payable to:
Nashville, TN 37243-1150
(800) 544-7693 or (615) 253-2144
State of Tennessee - LLE
Renewal Fee: $50.00
Late Fee:
$10.00 per month (max *3 months)
VERIFY STATUS
*Expired 3 months or more, must re-apply by
completing initial application for “Reinstatement”.
FOR OFFICE USE ONLY
License ID#
000
Exp. Date:
__________________
__________________
License Type: Prof 4001
/
LLE Renewal
Licensee Name
: ______________________________________________ (Jr., Sr.,III,IV)
Xact Type:
2010
Address
:
___________________________________________________
License ID#
______________
Entity# ________________
City, State, Zip
___________________________________________________
Application# ______________
Telephone:
___________________________________________________
Amount Paid: $_____________
□
□
Address Change:
No
Yes – Please notify the Board in writing of the address change prior to submitting the renewal or the license certificate
may not be mailed to the new address. May send update by email at: LLE.Renewal@tn.gov; or fax to (615) 532-2868 or by mail (separately from renewal).
1.
Have you received any criminal convictions that were not disclosed previously?
□
□
No
Yes
If ‘Yes’, You are required to submit, UNDER SEPARATE COVER, the following documentation to the Board’s office:
a)
Written explanation describing the circumstances surrounding the conviction(s); AND
b)
Certified copy of your conviction record(s) from the court(s).
Disclosure does not prevent a license from being renewed without the opportunity for a hearing of charges. However, failing to disclose
Information is a violation of the law, where disciplinary action may be imposed, as well as, license revocation. (See T.C.A. §62-6-118)
2.
Have you had complaints, liens, or unpaid judgments rendered that was not disclosed previously?
□
□
No
Yes
If ‘Yes’, You are required to submit, UNDER SEPARATE COVER, the following documentation to the Board’s office:
a)
Written explanation describing the circumstances surrounding the filing; AND
b)
Certified copy of the filing and disposition record(s) from the court(s).
Disclosure does not prevent a license from being renewed without the opportunity for a hearing of charges. However, failing to disclose information
is a violation of the law, where disciplinary action may be imposed, as well as, license revocation. (See T.C.A. §62-6-118)
3.
I understand pursuant to Rule 0680-3-.01, an LLE is not authorized to use the title ‘contractor’ unless they also hold a valid contractor’s license.
□
□
Yes
No
If ‘No’, you should review the Board’s laws, rules and regulations for clarification (see T.C.A. §62-6-130).
4.
I understand an LLE is limited to projects/contracts less than $25,000 and cannot be split into phases; a contractor’s license with a CE classification is
required when the total cost is $25,000 or more.
□
□
Yes
No
If ‘No’, you should review the Board’s law, rules and regulations for clarification (see T.C.A. §62-6-103).
5.
I understand that I must also abide by state and local municipality requirements, including but not limited to obtaining permits for inspections.
□
□
Yes
No
If ‘No’, you should review the Division of Fire Prevention’s website at:
I certify this is my license and I am the person approved by the Board for licensure. All information contained herein is true and accurate
to the best of my knowledge.
(Note: Licenses are not transferable)
___ ___ ___ - ___ ___ - ___ ___ ___ ___
________________________________________
_____/______/______
Social Security#:
Signature
Date
(SS# is not part of public record [Authority 42 USC 666])
(Rev.07/16)
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