Request For License Verification Form - Tennessee Board For Licensing Contractors

State of Tennessee

Board for Licensing Contractors

500 James Robertson Pkwy., Nashville, TN 37243

1-800-544-7693 Fax (615) 532-2868

Website:

Email:

Contractors.Home-Improvement@TN.Gov

REQUEST FOR LICENSE VERIFICATION

Instructions to Applicant:

Complete the “Applicant Information” section below and forward to the reciprocal State

verifying the licensing information for a trade exam waiver. Return it to us by including it with your contractor’s license

application in lieu of the “trade” exam score.

CONTRACTOR LICENSE APPLICANT INFORMATION

License Name:

Address:

City:

State:

Zip Code:

Telephone: (

)

-

Fax#: (

)

-

Contract Person:

E-Mail Address:

Signature:

Date:

If you are licensed with one of the following state agencies, Tennessee has entered into a trade exam waiver agreement and you may qualify

to have the trade exam waived: Alabama – (General, Electrical, Residential, and HVAC); Arkansas (General Contracting); Georgia (Commercial);

Louisiana; Mississippi, North Carolina (Residential/Commercial); Ohio (Electrical; Plumbing; and HVAC); and South Carolina. (Note: The Board

also accepts the NASCLA National Commercial trade exam). Reciprocation is with the TRADE exam, only.

LICENSE VERIFICATION

Instructions for Verifying State:

The above name applicant has submitted an application for a

contractor’s license with this Board. Please complete the following and return this form to the applicant.

License Name: ___________________________________________________________________________________

License ID#:

_______________ Date Issued: ________________ Status: ___Active ___*Inactive ___*Expired

Expiration Date: _______________ Disciplinary Action: ____No ___*Yes

*Does not qualify for exam waiver

License Classification(s):

Qualifying Agent’s

Trade Exam

Exam Type

Exam Date

Score

Waiver

Name

Residential,

(PSI, NAI, Experior,

(Endorsement; Prior to

Commercial,

Block, NASCLA, In-

Exam;, Not Required, etc.

Electrical, etc.)

House, etc.)

Signature:_____________________________________ Title: _________________________ Date: ______________

-State Seal -

State Agency: ____________________________________________________________

T.C.A. § 12-4-801 - Bid Preference Law - A like reciprocal preference is allowed to the lowest responsible bidder to a contractor who is either a resident of this state or is a

resident of another state.