Licensing Board Check lists for Contractor’s License ppesestba ie ters tad Seriniee nin (olewine ooeenae GEA ane teat pe Ccie neers 3: bank soengy of R000 4. Instrument bills and testing certificate from Astt. Elect Inspector Saaheal ce tal arenes Fee aes) eles, ical tenes pak Nees peek 1 Oriel Galan of R000. FORM ‘J’ (See Regulation-38) Application for an Electrical Contractor's License (To be filled in Gujarati, Hindi, or English) 1 Name (title) in which an Electrical | Contractor's License is applied for Business Address. 3 [Full name, home address and Age of the Proprietor/Partners if 2 3. 4 _ | if a Contractor’s License has been previously granted details to be given. 5 | Previous experience with Licensed Electrical Contractor. € _ | Detail of Permit held by the applicant | and/or Partner. 7 | Detail of the permit holder on the strength of whose permit the Contractor’s License is applied for. ® | Fee paid in to the Government Treasury 7 | Challan State Bank Of India original with the application) The applicants shall, as prescribed by the Secretary Licensing Board, produce evidence of solvency and capability to undertake wiring works. Note 17 We. jereby declare that the particulars stated above are correct to the best of my / our knowledge and that | / We fully understand the terms and conditions under which and Electrical Contractor’s License is granted a breach ‘of which will render the license liable for suspension or withdrawal.Licensing Board 1/ We.numuhereby also declare that | / We have in my / our possession a latest copy of the “Regulations and Conditions for the grant of certificates of competency and permit to supervisors and wiremen and Licenses to Electrical Contractors and other matters connected therewith” and that | / We shall notify the Secretary Licensing Board, every change of address. Date:- Signature of Proprietor / Partner