Psi Electrical Experience Verification Form printable pdf download

PSI ELECTRICAL EXPERIENCE VERIFICATION

NEW MEXICO CONTRACTOR LICENSING SERVICE

THIS WORK EXPERIENCE VERIFICATION MUST BE SUBMITTED WITH AN APPLICATION AND

APPROVED BEFORE EXAMS MAY BE SCHEDULED.

TYPE OR PRINT CLEARLY. INCOMPLETE OR ILLEGIBLE FORMS WILL NOT BE PROCESSED.

PLEASE READ THE FOLLOWING INSTRUCTIONS PRIOR TO COMPLETING THE ATTACHED WORK EXPERIENCE VERIFICATION.

FOLLOWING INSTRUCTIONS COMPLETELY WILL AVOID DELAYS IN PROCESSING APPLICATION.

INSTRUCTIONS FOR THE APPLICANT

Only the top portion of the Affidavit is to be completed by the Applicant. Complete ALL information requested

For a description of the scope of work allowed under each classification, please refer to the Regulation and Licensing

Department, New Mexico Administrative Code, Classifications and Scopes (section 14.6.6.9 of the New Mexico Administrative

Code, found online at ).

One or more forms may be completed and submitted to meet the experience requirements. *ALL EXPERIENCE MUST BE WITHIN

THE LAST 10 YEARS. Approval shall be given to test ONLY for the license classifications(s) listed on the Affidavit.

NOTE: You may include education/technical training to satisfy the experience requirements. For qualifying party candidates,

each year of training may be credited as one-half (1/2) year of experience, but in no case shall credited training exceed one-half

(1/2) of the total experience requirement. Journeyman applicants may use credited training to satisfy the entire experience

requirement if approved. (This does not apply if you are applying for the EE98J or ER1J) Please include copies of your official

transcripts and/or certificates.

INSTRUCTIONS FOR EXPERIENCE VERIFICATION

Individuals who are qualified to complete the Affidavit are as follows: Employers (past or present), Supervisors, Foremen, and

DO NOT LEAVE ANY BLANKS.

other Contractors. Answer all the questions completely and fully.

Supervisors and foremen must submit proof/verification of their position within the company. Out of state Contractors must

attach a copy of their current state license to the affidavit. You must submit proof/verification that the company is an

active/valid company. (Tax certificate, business license listing the company name, corporation papers, etc.)

*The work experience verification must be signed by the person certifying the experience and notarized.

*All attachments must be signed by the person certifying the work experience.

All experience must have been gained while employed by a contractor licensed in the trade being applied for, or considered

legal work in the state in which the work was performed. There may be some limited exceptions to this work experience

requirement. For example certain military, out of the country, and homeowner experience may be used in some circumstances.

Please contact PSI for more information regarding these exceptions. Work experience requirements are a minimum of:

TWO YEARS (4,000 HOURS)

FOUR YEARS (8,000 hours)

ER1, ER1J

EE98, E98J

ES1, ES1J

EL1, EL1J

ES2, ES2J

ES3, ES3J

ES7, ES7J

APPLICANT: Upon completion of the Affidavit, please deliver original(s) by mail or in person to:

PSI, 2301 YALE BLVD, SE, SUITE C4, ALBUQUERQUE, NM, 87106

(Please include a self-addressed, stamped envelope)

Please allow 7 to 10 working days for processing.

If approved, PSI will mail you an eligibility card containing exam registration and scheduling information.

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Updated 6/20/2014

Psi Electrical Experience Verification Form

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