Home Improvement Contractor Trust Fund Enrollment Form - Nyc Department Of Consumer Affairs

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HOME IMPROVEMENT CONTRACTOR
42 Broadway
New York, NY 10004
TRUST FUND ENROLLMENT FORM
Dial 311
(212-NEW-YORK)
Applicants who enroll in the Trust Fund must pay a $200 fee to the New York
nyc.gov/consumers
City Department of Consumer Affairs (DCA) as part of the application process.
Applicants who do not enroll in the Trust Fund must post and maintain a bond.
Please complete the information below to enroll your business in the Trust
Fund.
Legal Name of Business:
Business’s Trade or Doing-
Business-As (DBA) Name, if
applicable:
Business Address:
All payments to the Trust Fund will be held in trust by the Fund for the benefit of
the license industry and are non-refundable as long as the Fund exists. If the
Fund dissolves, Fund monies will be distributed equally to Fund contributors
who are licensed at the time the Fund dissolves.
If a licensee fails to comply with the laws, rules, and regulations enforced by
DCA and DCA has exhausted all administrative steps, including revocation of a
license, Fund money will be used to satisfy a DCA order. After reviewing Fund
resources, the Commissioner or the Commissioner’s designee will decide
whether to order partial payment of awards, fines, and/or judgments from the
Fund. Any payment of awards, fines, and/or judgments from the Fund does not
relieve the licensee from legal obligations to satisfy DCA orders and/or court
judgments.
I have read and agree to the conditions outlined above.
____________________________________
________________________________
Signature of License Applicant
Title/Position (if any)
____________________________________
________________________________
Print Full Name
Date
Updated 02/05/2015

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