Printable Iowa Electrician License Application Form in PDF Modify Form Online

Printable Iowa Electrician License Application Form in PDF

The Iowa Electrician License Application form serves as a vital step for professionals in the electrical field seeking formal recognition and the ability to operate within Iowa's regulatory standards. This comprehensive application requires detailed personal information, proof of educational background, practical electrical work experience, and other specifics to ensure the applicant meets the full criteria set by the Iowa State Electrical Board. With various types of licenses available, applicants must carefully follow the instructions to submit a complete and accurate application.

To start your journey toward becoming a licensed electrician in Iowa, ensure your application is complete by clicking the button below.

Modify Form Online
Content Navigation

Navigating through the process of acquiring an electrician's license in Iowa requires a thorough understanding of the application form made available by the Iowa State Electrical Board. This comprehensive form, designed to gather essential information from applicants, mandates meticulous attention to detail to ensure completeness and accuracy. Upon submission, each application must be filled out in black or blue ink and signed by the applicant, emphasizing the state's commitment to maintaining high standards within the electrical profession. The form is structured to accommodate various types of licenses, including Electrical Contractor, Master Electrician (Class A and Class B), Residential Electrician, and more, each with specific sections that must be completed based on the license type desired. Applicants are also required to disclose personal information, educational background, current licenses held, work experience, and references, establishing a profile that the board uses to assess their eligibility. The instructions stipulate the necessity of submitting the application on single-sided plain paper, further detailed by an included matrix that identifies the relevant parts of the form to be filled out according to the type of license being applied for. Additional documents, such as the Combined Check Worksheet for those paying for multiple applications with one check, underscores the board’s organized approach to processing applications. Ultimately, this form serves not only as a procedural hurdle but as a filtration system, ensuring that only qualified individuals are granted the privilege to practice as licensed electricians in Iowa.

Iowa Electrician License Application Preview

INSTRUCTIONS FOR APPLICATION FOR ELECTRICIAN'S LICENSE

IOWA STATE ELECTRICAL BOARD

Instructions for Filling out the Application for Electrician’s License

AN APPLICATION IS NOT CONSIDERED COMPLETE AND WILL NOT BE PROCESSED UNTIL

ALL ITEMS HAVE BEEN SUBMITTED AS REQUIRED

The application must be completed and signed by the applicant. All information must be typed or clearly printed

in black or blue ink using upper cases letters. The application and all attachments must be submitted on separate pieces of single-sided, 8½‖ x 11‖ plain paper. Please use a paper clip to fasten all pages together, with the check

or money order on top. Do not use staples, use only plain paper.

If one check will be used to pay for multiple applications, a Combined Check Worksheet must be completed and submitted with the applications and payment. The Combined Check Worksheet is available on the

Department’s Website.

All CHECKS TO BE MADE PAYABLE TO: TREASURER- STATE OF IOWA

THE FOLLOWING MATRIX SHOULD BE USED TO DETERMINE WHICH PORTIONS OF THE LICENSE APPLICATION ARE REQUIRED TO BE FILLED OUT BASED ON THE TYPE OF LICENSE THAT IS DESIRED.

Type of

Part 1

Part 2

Part 3

Part 4

Part 5

Part 6

Part 7

Part 8

Part 9

Class B

Certificate

License

License

Personal

Educational

Current

Screening

Practical

Verifiable

Applicant

Electrical

Affidavit/

of

 

Type

Information

Record

Electrical

Questions

Electrical

Electrical

Signature

Contractor

Special

Responsible

 

 

 

 

Licenses

 

Work

Work

 

 

Electrician

License

 

 

 

 

in Force

 

Experience

Experience

 

 

Affidavit

Master

 

 

 

 

 

 

 

 

 

 

 

 

Electrical

X

X

 

X

X

 

 

X

X

 

X

Contractor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Residential

X

X

 

X

X

 

 

X

X

 

X

Contractor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Class A

X

X

X

X

X

X

X

X

 

 

 

Master

 

 

 

 

 

 

 

 

 

 

 

Electrician

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Class B

X

X

X

X

X

X

X

X

 

X

 

Master

 

 

 

 

 

 

 

 

 

 

 

Electrician

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Residential

X

X

X

X

X

X

X

X

 

 

 

Master

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Class A

X

X

X

X

X

X

X

X

 

 

 

Journeyman

 

 

 

 

 

 

 

 

 

 

 

Electrician

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Class B

X

X

X

X

X

X

X

X

 

X

 

Journeyman

 

 

 

 

 

 

 

 

 

 

 

Electrician

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Residential

X

X

X

X

X

X

X

X

 

 

 

Electrician

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Special

X

X

X

X

X

X

X

X

 

 

 

Electrician

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Apprentice

X

X

X

 

X

X

X

X

 

 

 

Electrician

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unclassified

X

X

X

 

X

X

X

X

 

 

 

Person

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ALL APPLICANTS MUST PROVIDE QUALIFICATIONS FOR TYPE OF LICENSE DESIRED

Part 1 – LICENSE TYPE

1.DESIGNATE TYPE OF LICENSE DESIRED: - Indicate the type of license desired by checking the appropriate boxes

Electrical ContractorA person affiliated with an electrical contracting firm or business who is licensed by the board as either a Class A or Class B Master Electrician and who is also registered with the state of Iowa as a contractor

Residential ContractorA residential electrical contractor license may be issued to a person who is licensed as a class A master electrician, a class B master electrician, or a residential master electrician and who is registered with the state of Iowa as a contractor.

Master ElectricianA person having the necessary qualifications and technical knowledge to properly plan, lay out, and supervise the installation of electrical wiring and equipment for light, heat, and power.

Class A - License was obtained by written supervised examination and is not subject to the restrictions of a Class B license

Class BLicense is granted by proven experience since 1998. License is subject to restrictions by the board and local political subdivisions.

Residential MasterA residential master electrician license may be issued to a person who submits to the board a completed application with the applicable fee, who is not disqualified from holding a license pursuant to rule 661502.4(103), and who meets one of the following requirements: A. Holds a current residential electrician or journeyman electrician license, has 2,000 hours of

verified experience as a residential electrician or a journeyman electrician, and has passed a residential master electrician examination approved by the board; or

B. Holds a current special electrician license with a residential endorsement, has 4,000 hours of verified experience, and has passed a residential master electrician examination approved by the board.

Journeyman ElectricianPersons having the necessary qualifications to wire for or install electrical wiring and equipment.

Class A - License was obtained by written supervised examination and is not subject to the restrictions of a Class B license

Class BLicense is granted by proven experience since 1998. License is subject to restrictions by the board and local political subdivisions.

Residential ElectricianA residential electrician license may be issued to a person who submits to the board a completed application with the applicable fee, who is not disqualified from holding a license pursuant

to rule 661502.4(103), and who meets one of the following requirements:

A. Holds a current residential special electrician license and has held that license for a minimum of one year and has passed a residential electrician examination approved by the board; or

B. Has completed 6,000 hours of experience as an apprentice electrician and has passed a residential electrician examination approved by the board. An applicant may take the examination required by this paragraph after completing 5,000 hours of experience as an apprentice electrician, although the license will not be issued until the applicant has completed 6,000 hours of such experience; or

C. Has completed 4,000 hours of experience working under the direct supervision of a residential master electrician, a residential electrician, a master electrician, or a journeyman electrician; has successfully completed a minimum of one academic year of electrical trade school; and has passed a residential electrician examination approved by the board; or

D. Has completed 8,000 hours of verified experience as a licensed unclassified person and at least 2,000 hours of verified work experience in residential wiring and has passed a residential electrician examination approved by the board; or

E. Has successfully completed a residential electrician apprenticeship program approved by the United States Department of Labor and passed a residential electrician examination approved by the board

Special ElectricianA person having the necessary qualifications to install special classes of electrical wiring, apparatus, equipment, or installations which shall include irrigation system wiring, disconnecting and reconnecting of existing air conditioning and refrigeration equipment, and sign installations.

Apprentice ElectricianA person who is engaged in learning and assisting in the installation, alteration, and repair of electrical wiring, apparatus, and equipment as an employee of a person licensed by the board and is progressing toward the completion of an apprenticeship program registered by the bureau of apprenticeship and training with the United States Department of Labor.

Unclassified PersonAny person other than an apprentice electrician or other person licensed under this licensing act, who , as such person’s principal occupation, is engaged in learning and assisting in the installation, alteration, and repair of electrical wiring, apparatus, and equipment as an employee of a person licensed under this licensing act.

2. APPLICATION FOR LICENSE BY:

ExaminationCheck this box if you plan to take an examination sponsored by the state of Iowa to obtain an electrical license. All experience requirements and qualifications per the State Electrical Board must be met to allow one to take the examination.

ReciprocalCheck this box if you intend to obtain your license through reciprocity with states that have entered into a reciprocity agreement with the state of Iowa. At this time, Iowa does not have any reciprocity agreements with any other state. Please check the following website for updates of reciprocity agreements. http://www.dps.state.ia.us/fm/electrician/index.shtml

Proof of Work ExperienceCheck this box if you intend to obtain a Class B license by providing proof of work experience

Existing City License in IowaCheck this box if you intend to obtain a license by indicating that you currently possess an electrical license that was obtained through a local Iowa political subdivision that required the passing of a written supervised examination in order to obtain licensure. Provide a copy of the license with your application.

Part 2- PERSONAL INFORMATION

NAMEFull Name of applicant Electrical Contractor Business Name is required in a later section

SOCIAL SECURITY NUMBERProvide the Social Security number that is used by the applicant. All social security numbers will be kept confidential

MAILING ADDRESS (Mailing Address, City, County, State, Zip Code) - Write the mailing address of the applicant

Part 3 - EDUCATIONAL RECORD

If none of the questions apply, check the NO box for each question and continue to the next section of the form.

Part 4 -CURRENT ELECTRICAL LICENSES IN FORCE

If you do not currently have any electrical licenses in force, leave this section blank or write ―NONE‖ next to CURRENT LICENSES IN FORCE Column.

Type of license, issuing jurisdiction, license number, year license issued, and expiration date of licenseEnter the type of license (master, journeyman, electrical contractor, etc.), Jurisdiction that issued license (i.e. City of Des Moines, State of Nebraska, Linn County), License Number, Year license was issued (Original Issue Date), and expiration date of license

IS THIS LICENSE CURRENT/ ACTIVE?Check the appropriate box if your current license is active and up to date.

WAS THE LICENSE OBTAINED BY EXAMINATION?Check the appropriate box if the license you currently hold was obtained by passing a written supervised examination.

Part 5 – SCREENING QUESTIONS

Answer all questions in this section. Failure to do so could result in your license being delayed.

Part 6- PRACTICAL ELECTRICAL WORK EXPERIENCE

For Class B License Work Experience please refer to page 5.If you are applying for a Class B license, page 5 is required to be filled out as well as the verifiable electrical work experience section.

PRATICAL ELECTRICAL EXPERIENCEOn the left side of the section provide the amount of time the applicant was performing at the various levels of electrical occupations. On the right side of the section provide the percentage of time that the applicant spent in each type of work. The total percentage should add up to 100%.

REFERENCES: - Provide 3 persons or firms, preferably in the electrical industry, to be used as references

REMARKS: - Space provided for comments or additional information that would assist the board in evaluating your application.

Part 7 - VERIFIABLE ELECTRICAL WORK EXPERIENCE

Name of Current/ Previous EmployerProvide names of present and previous employers. If self employed, list company name and indicate self- employed.

Mailing Address(Mailing Address, City, State, Zip Code) Mailing Address of Employer

Reason for LeavingIndicate reason for leaving (i.e. Better Opportunity, Resigned, Laid Off, Fired, etc.)

DutiesProvide an explanation of the nature of work that the applicant performed during employment (i.e. 3 months installing residential wiring or 15 months installing commercial wiring)

Part 8- APPLICANT SIGNATURESign and date the application

Please remember that the application must be completed in blue or black ink and all attachments must be submitted on separate pieces of single- sided, 8½‖ x 11‖ paper. Please use a paperclip to fasten all pages together. Do not use staples. Any deviation from these instructions may delay the

processing of your application.

Documents submitted with the application will not be returned. Keep a copy of the completed application, all attachments and your check. Do not submit forms that you did not have to complete.

Before you sign, carefully read the statement at the bottom of the application. Be aware that information provided on this application and any attachments are subject to audit. Providing false information may result in revocation of this license and imposition of administrative penalties.

Part 9- ELECTRICAL CONTRACTOR - This portion of the application to completed by those applying for an Electrical Contractor license. A Master Electrician license is required for an electrical contractor.

Name of Responsible Master Electrician – Print the name of the Responsible Master Electrician that is required to be or be employed by the Electrical Contractor

Name of Contractor Representative – Print the name of the Contractor Representative (i.e. owner, officer of corporation, etc.).

Have you completed and attached a Certificate of Responsible Licensed Master?Check the appropriate box. A Certificate of Responsible Master Electrician is required to obtain an Electrical Contractor License.

Business Name of ContractorEnter the business name of contractor as it appears on the Contractor Registration Form issued by the Iowa Division of Labor, except for an individual (sole proprietor) or a partnership making application using the individual’s or all partners’ own full true

name(s) as the contractor name. Examples of business names:

An individual without an assumed name John Doe or John Doe Electric

An individual with an assumed name John Doe dba Assumed Name

A partnership with an assumed name John Doe and Jane Doe dba Assumed Name

A corporation Company Name, Inc.

A corporation with an assumed name Company Name Inc. dba Assumed Name

A limited liability company Company Name, LLC or LLP

Business AddressAddress of the business

Mailing AddressRequired if different from business address

Are you registered as a contractor with the state of Iowa?Check the appropriate box. An electrical contractor is required to be registered as a contractor with the state of Iowa before they can receive an electrical contractor license. To check on the status of registration follow the web link: http://www.iowaworkforce.org/labor/contractor.htm

Iowa Division of Labor Contractor Registration # - Provide the registration number of the electrical contractor as provided by the Iowa Division of Labor. To check the requirements of the Iowa Division of Labor go to their web site at http://www.iowaworkforce.org/labor/contractor.htm

Federal Tax ID# or Employer Identification # - Provide the federal tax identification number or employer identification number assigned to the business by the U.S. Department of Treasury Internal Revenue Service. Sole proprietorships and partnership should provide their social security number(s) in lieu of the employer identification number. All employer identification numbers and social security numbers will be not be part of the public record and will be kept confidential.

Signature of Contractor RepresentativeContractor Representative to sign and date application

Signature of Responsible Master or Master ApplicantResponsible Master Electrician or Master Electrician Applicant to sign and date application

CLASS B AFFADAVIT FORMThis form is used to verify that you have been practicing as an electrician on or before 1990.

Print Name of Qualifying PartyPrint name of applicant applying for Class B license

Signature of Qualifying PartySignature of applicant applying for Class B license

Name of Business- Print Name of Business that applicant works for/ owns

DatePrint date that the form was filled out.

THIS FORM IS REQUIRED TO BE NOTARIZEDThe bottom of this form is required to be filled out by a notary of the public. A notary of the public is required to witness that the person signing this document is authentic.

A notary of the public in your area can be found at the following web site: http://www.sos.state.ia.us/notaries/index.html This website contains a searchable database of notaries of the public in your area.

CERTIFICATE OF RESPONSIBLE MASTERThis form is to designate a master electrician that is responsible for the electrical contractor

THIS FORM IS REQUIRED TO BE NOTARIZEDThe bottom of this form is required to be filled out by a notary of the public. A notary of the public is required to witness that the person signing this document is authentic.

A notary of the public in your area can be found at the following web site: http://www.sos.state.ia.us/notaries/index.html This website contains a searchable database of notaries of the public in your area.

COMBINED CHECK WORKSHEET

IOWA STATE ELECTRICAL BOARD

Contact Information

Name

Address

Telephone

Email

APPLICANT NAME

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

Add up each column

Multiply by Fee

Total fee due for each license type

Electrical

Contractor

Residential

Contractor

Class A

Master

Class B

Master

Residential

Master

Class A

Journeyman

Class B

Journeyman

Residential

Electrician

Special

Electrician

Apprentice or

Unclassified

Person

CHECK NUMBER

TOTAL DUE

Use this worksheet to submit one check to pay the fees for up to 20 applications. List each applicant’s name and mark the license type they are seeking in the appropriate column. Add all of the fees due and submit one check in that amount along with all of the applications. Please note that if the names listed on this worksheet do not match those on the applications submitted, or if the check is not for the correct amount, the applications will not be processed and the entire packet will be returned.

APPLICATION FOR ELECTRICIAN'S LICENSE

SUBMIT TO:

IOWA ELECTRICAL EXAMINING BOARD

ELECTRICAL EXAMINING BOARD

 

215 EAST 7TH STREET

 

DES MOINES, IA 50319

*APPLICABLE LICENSE FEE MUST ACCOMPANY THIS APPLICATION.

 

 

 

Please Type or Print Legibly

 

 

 

 

 

 

Part 1- LICENSE TYPE

 

 

 

 

 

 

 

 

 

 

 

 

1.DESIGNATE TYPE OF LICENSE DESIRED:

 

 

 

 

 

 

2.APPLICATION FOR LICENSE BY:

 

 

 

 

ELECTRICAL CONTRACTOR (See Fee Schedule)

 

 

 

 

 

EXAMINATION

 

 

 

 

 

 

MASTER - (See Fee Schedule)

CLASS A or

CLASS B

 

or

 

 

 

 

 

 

 

 

 

 

 

 

RESIDENTIAL MASTER - (See Fee Schedule)

 

 

 

 

 

 

 

RECIPROCAL

 

 

 

 

 

 

RESIDENTIAL CONTRACTOR - (See Fee Schedule)

 

 

 

 

or

 

 

 

 

 

 

 

 

 

 

 

 

RESIDENTIAL ELECTRICIAN - (See Fee Schedule)

 

 

 

 

 

PROOF OF WORK EXPERIENCE (Class B or

 

JOURNEYMAN - (See Fee Schedule)

CLASS A or

CLASS B

Special Electrician Endorsements)

 

 

 

 

SPECIAL ELECTRICIAN - (See Fee Schedule)

 

 

 

 

 

 

or

 

 

 

 

 

 

 

 

 

 

 

 

Special Electrician Endorsements: (Check the appropriate endorsement that you

 

EXISTING CITY LICENSE IN IOWA (Provide copy of

 

would like to receive. You may check multiple endorsements.)

 

 

 

 

 

 

 

 

 

existing license and testing results)

 

 

 

 

 

 

 

Irrigation System Wiring

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Disconnect/ Reconnect Existing Air Conditioning or

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Refrigeration Equipment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Sign Installation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APPRENTICE ELECTRICIAN - (See Fee Schedule)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

UNCLASSIFIED PERSON - (See Fee Schedule)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

All licenses valid for three years, except apprentice and unclassified

 

 

 

 

 

 

 

 

 

 

 

 

 

 

licenses. Apprentice licenses and unclassified persons are valid for one

 

 

 

 

 

 

 

 

 

 

 

 

 

 

year.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Part 2- PERSONAL INFORMATION

 

 

 

 

 

 

 

 

 

Name (Last, First, Middle)

 

 

 

 

 

 

Social Security Number

Date of Birth

Telephone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(

 

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address (Street or P.O. Box)

 

 

 

 

 

 

 

 

 

 

 

 

 

Email Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

County

 

 

 

 

 

State

 

 

 

 

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Part 3 - EDUCATIONAL RECORD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TYPE

 

YES

NO

 

DATES ATTENDED

 

NAME & LOCATION OF SCHOOL OR

DATE DIPLOMA OR

 

 

 

 

 

 

 

 

FROM

 

TO

 

TRADE ASSOCIATION

 

 

 

DEGREE RECEIVED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Attach copy of degree)

 

Have you completed a two-year post

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

high school course in electrical wiring

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

from which you received a Degree in

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Electrical Technology?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Have you completed a four-year or

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

five-year apprentice electrician

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

program?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Part 4 -CURRENT ELECTRICAL LICENSES IN FORCE

 

 

 

 

 

 

 

 

(If needed, attach an additional sheet in the same format)

 

 

 

 

 

 

 

 

 

TYPE OF

ISSUING JURISDICTION

 

 

LICENSE #

 

 

 

YEAR

EXPIRATION

IS THIS LICENSE

 

WAS THE LICENSE

 

LICENSE

 

 

 

 

 

 

 

 

 

 

LICENSED

DATE

CURRENT/

 

 

OBTAINED BY

 

 

 

 

 

 

 

 

 

 

 

 

ISSUED

 

 

 

ACTIVE?

 

 

EXAMINATION?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YES

 

NO

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YES

 

NO

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YES

 

NO

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Page 1

Part 5- SCREENING QUESTIONS

1.Have you previously filed an application with this state for an electrician’s license? Yes No

2.Have you previously been examined for an

electrician’s license by this Board? No Yes

3.Are you registered with U.S. Department of Labor as an Apprentice Electrician? Yes No

4.Have you ever been convicted of a felony under the laws of this state or any other jurisdiction? Yes No -- If yes, please explain fully on a separate sheet of paper.

5.Have you ever entered a plea of guilty to a felony or a plea of no contest accepted by the court in this state or any other jurisdiction?

Yes No -- If yes, please explain fully on a separate sheet of paper.

6.Have you ever been denied application or licensure as an electrician or been disciplined and/or revoked with regard to the practice of electrical wiring or practiced electrical wiring in violation of this state’s law or any other jurisdiction?

Yes No -- If yes, please explain fully on a separate sheet of paper.

7.Have you been practicing solely within a jurisdiction where you held an electrical license but are now seeking a State of Iowa license?

Yes No

8.Are you applying for a State of Iowa license because you were previously holding an electrical license issued by a jurisdiction that is discontinuing its licensing program?

Yes No

9.Have you been practicing as an electrician or electrical contractor in Iowa without a jurisdiction or State of Iowa license since January 1, 2008 where licensure was required?

Yes No

10.Have you previously had a license issued by the Electrical Examining Board that was suspended or revoked?

Yes No

Page 2

Part 6- PRACTICAL ELECTRICAL WORK EXPERIENCE

List the Total Number of months of electrical

Type of Wiring Experience

experience in each category

With reference to your electrical experience, indicate the percentage of time spent in each type of work,

 

listed below.

CATEGORY

 

TIME IN

Commercial, Industrial, Public Buildings, and

 

%

 

 

MONTHS

Multi-Family Dwellings over 2 Living Units

 

 

 

 

 

 

 

Apprentice

 

 

Residential (2 Living Units or Less)

 

%

 

 

 

 

 

 

 

Journeyman

 

 

Farm and Agricultural Wiring

 

%

 

 

 

 

 

 

 

Job Superintendent or

 

 

Irrigation Equipment

 

%

Foreman

 

 

 

 

 

 

 

 

 

 

 

 

 

Owner or Manager

 

 

Installing Home Appliances

 

%

 

 

 

 

 

 

 

Estimator

 

 

Fire Alarm Systems

 

%

 

 

 

 

 

 

 

Other (Specify)

 

 

Heating & Air Conditioning Equipment

 

%

 

 

 

 

 

 

 

Total

 

 

Refrigeration Systems

 

%

 

 

 

 

 

 

Total work verifiable electrical work

Other (Explain in detail on separate sheet)

 

%

experience must equal or exceed

 

 

 

 

requirements for the type of license

 

 

 

 

requested. 1 year =2,000 hours

 

 

 

 

FOR CLASS B LICENSES OR SPECIAL ELECTRICIAN ENDORSEMENTS, THE AFFIDAVIT OF WORK EXPERIENCE

 

 

MUST BE COMPLETED IN ADDITION TO PART 6 AND 7 OF THIS APPLICATION

 

 

 

 

REFERENCES

 

List three persons or firms engaged in electrical industry preferred

 

 

 

Name

 

Address & Phone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REMARKS

USE THIS SPACE TO PROVIDE ANY ADDITIONAL LICENSE, EXPERIENCE, EDUCATION OR INFORMATION THAT WOULD ASSIST THE BOARD IN EVALUATING YOUR APPLICATION

Page 3

 

 

 

Part 7 - VERIFIABLE ELECTRICAL WORK EXPERIENCE

 

 

Provide verifiable electrical work experience for the last 10 years. If needed, attach an additional sheet in the same format

 

The Board may verify all employment data with present and former employers.

 

NAME OF CURRENT EMPLOYER

 

 

DUTIES

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF EMPLOYMENT

JOB TITLE

 

 

FROM:

TO:

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYER’S TELEPHONE NUMBER & AREA CODE

 

 

 

(

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REASON FOR LEAVING:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF PREVIOUS EMPLOYER

 

 

DUTIES

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF EMPLOYMENT

JOB TITLE

 

 

FROM:

TO:

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYER’S TELEPHONE NUMBER & AREA CODE

 

 

 

(

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REASON FOR LEAVING:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF PREVIOUS EMPLOYER

 

 

DUTIES

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF EMPLOYMENT

JOB TITLE

 

 

FROM:

TO:

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYER’S TELEPHONE NUMBER & AREA CODE

 

 

 

(

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REASON FOR LEAVING:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF PREVIOUS EMPLOYER

 

 

DUTIES

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF EMPLOYMENT

JOB TITLE

 

 

FROM:

TO:

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYER’S TELEPHONE NUMBER & AREA CODE

 

 

 

(

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REASON FOR LEAVING:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF PREVIOUS EMPLOYER

 

 

DUTIES

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF EMPLOYMENT

JOB TITLE

 

 

FROM:

TO:

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYER’S TELEPHONE NUMBER & AREA CODE

 

 

 

(

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REASON FOR LEAVING:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF PREVIOUS EMPLOYER

 

 

DUTIES

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF EMPLOYMENT

JOB TITLE

 

 

FROM:

TO:

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYER’S TELEPHONE NUMBER & AREA CODE

 

 

 

(

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REASON FOR LEAVING:

 

 

 

 

 

 

 

 

 

 

Page 4

Form Information

Fact Number Description
1 The application must be fully completed and signed to be processed.
2 Information on the application must be typed or printed in black or blue ink using uppercase letters.
3 Applications and attachments must be submitted on 8½" x 11" plain paper without staples, fastened with a paperclip.
4 Checks for the application fee must be payable to Treasurer-State of Iowa.
5 A Combined Check Worksheet is required when a single check is used for multiple applications.
6 There are different sections of the application that must be completed based on the type of electrician license being applied for.
7 Applicants must designate the type of license desired and how they are applying, including by examination, reciprocity (although Iowa currently has no reciprocity agreements), proof of work experience, or an existing city license in Iowa.
8 Personal information section requires full name, social security number (kept confidential), and mailing address.
9 Educational record, current licenses, work experience, and screening questions are parts of the application, varying based on the specific license applied for.
10 The application includes sections for Electrical Contractor applicants to provide information about the responsible master electrician and contractor representative, including a requirement for certain forms to be notarized.

Detailed Guide for Writing Iowa Electrician License Application

When applying for an electrician license in Iowa, the process is straightforward, but attention to detail is critical. Each applicant must ensure their application is complete and accurate before submission to avoid any delays. This involves filling out the application meticulously, attaching all required documents, and submitting the application fee. The following steps guide you through the process of filling out the Iowa Electrician License Application form, ensuring a comprehensive and orderly approach to acquiring your professional license.

  1. Preparation: Before starting, ensure you have access to a printer and black or blue ink for completing the application. Gather all necessary information and documents you will need to provide.
  2. Complete Part 1 – LICENSE TYPE: Check the appropriate box to indicate the type of license you are applying for. Consider your qualifications and the nature of your electrical work to determine the correct license type.
  3. Choose Application Method in Part 1: Indicate whether you are applying by Examination, Reciprocal agreement, Proof of Work Experience, or with an Existing City License in Iowa.
  4. Fill in Part 2 – PERSONAL INFORMATION: Write your full name, social security number, and mailing address clearly.
  5. Answer Part 3 – EDUCATIONAL RECORD: Check the appropriate boxes to indicate your educational background. If none apply, mark "NO" for each question.
  6. Provide Part 4 – CURRENT ELECTRICAL LICENSES IN FORCE: List any current electrical licenses, including the type, issuing jurisdiction, license number, issue and expiration dates. If you have no current licenses, indicate "NONE."
  7. Respond to Part 5 – SCREENING QUESTIONS: Answer each question honestly. Failure to complete this section can delay the processing of your application.
  8. Detail Part 6 – PRACTICAL ELECTRICAL WORK EXPERIENCE: For a Class B license, refer to page 5. Otherwise, detail your practical electrical experience, including the roles and percentage of time spent in each role.
  9. Document Part 7 – VERIFIABLE ELECTRICAL WORK EXPERIENCE: List your current and previous employers, mailing addresses, reasons for leaving, and a brief description of duties.
  10. Sign Part 8 – APPLICANT SIGNATURE: Review the application, ensure all information is correct and complete, then sign and date the application.
  11. If applicable, complete Part 9 – ELECTRICAL CONTRACTOR: This section is necessary if you are applying for an Electrical Contractor license. Include information about the Responsible Master Electrician and the Contractor Representative, and ensure to attach a Certificate of Responsible Licensed Master.
  12. Attach the payment: Attach a check or money order for the application fee to the front of your application. If paying for multiple applications with one check, include a completed Combined Check Worksheet.
  13. Finalize: Use a paperclip to fasten all pages of the application and any additional documents together. Do not use staples. Ensure everything is completed in black or blue ink and submitted on single-sided, plain 8½" x 11" paper.

Once your application is complete, review all sections one last time for accuracy and completeness. Remember, an application will not be processed until it is fully complete. After submission, your application will be reviewed by the Iowa State Electrical Board. It's important to keep a copy of the completed application, all attachments, and your check or money order for your records. By following these steps carefully, you will increase the likelihood of a smooth application process.

Get Answers on Iowa Electrician License Application

What is required to complete the Iowa Electrician License Application?

To ensure the application is processed without delays, it must be filled out completely and signed by the applicant. Information should be typed or printed clearly in black or blue ink, using upper case letters. The application and all attachments should be submitted on 8½" x 11" plain paper and secured with a paper clip, avoiding the use of staples. If paying for multiple applications with one check, a Combined Check Worksheet from the Department’s website must also be submitted. The application matrix provided in the instructions helps determine which parts of the application need to be filled out, based on the type of license desired.

What types of licenses can be applied for, and what qualifications are needed?

There are several types of licenses available including Electrical Contractor, Residential Contractor, Master Electrician (Class A and B), Residential Master Electrician, Journeyman Electrician (Class A and B), Residential Electrician, Special Electrician, Apprentice Electrician, and Unclassified Person. The specific qualifications for each license vary, involving combinations of examinations, verified work experience, and, in some cases, completion of apprenticeship programs or holding current related licenses. Details of the specific requirements for each license type are outlined in the instructions for the application form.

How can I pay for my license application, and how should payment be submitted?

Payments for license applications should be made by check or money order payable to the Treasurer- State of Iowa. Payments must be included on top of the application packet secured by a paper clip. If one check is being used to pay for multiple applications, a Combined Check Worksheet, available on the Department’s website, must be completed and included with the applications.

What if I want to apply for a license through reciprocity with another state?

As mentioned in the instructions, Iowa currently does not hold reciprocity agreements with other states for electrical licensing. Applicants who seek to obtain a license through reciprocity should check the official website for updates regarding any future reciprocity agreements.

What should I do if I don't currently hold any electrical licenses?

If you do not hold any current electrical licenses, you should leave the section for current electrical licenses in force blank or write “NONE.” This will not affect the processing of your application for the type of license you are applying for, provided you meet the other qualifications required for that license.

What happens if I provide false information on my application?

Applicants are advised to carefully read and review all information provided on the application and its attachments. The submission of false information may lead to the revocation of the granted license and the imposition of administrative penalties. All applications and attachments are subject to audit by the Iowa State Electrical Board.

Common mistakes

  1. Applicants often neglect to select the type of license they are applying for. This choice dictates which parts of the application need to be completed. Not specifying the license type can lead to incomplete applications, causing delays.

  2. Filling out the application in ink other than black or blue or not using uppercase letters is a common mistake. The instructions specify these requirements to ensure clarity and legibility, which are crucial for processing the application efficiently.

  3. Many applicants forget to attach a Combined Check Worksheet when a single check is used to pay for multiple applications. This oversight can result in payment processing errors and potential delays in the application review.

  4. Another frequent error is the failure to provide proof of work experience for Class B licenses. This documentation is vital to validate the applicant’s qualifications and eligibility for the license they are seeking.

  5. Applicants often submit applications with staples rather than paper clips. This contradicts the specific instructions provided and may cause damage to the documents during processing.

  6. Not all applicants remember to sign and date the application. This final step is crucial; an unsigned application is incomplete and cannot be processed, leading to unnecessary delays.

  7. Some applicants fail to check the website for updates on reciprocity agreements with other states when applying for a license through reciprocity. Staying informed of current agreements can significantly impact the application process.

  • Completing the application accurately and according to the instructions ensures swift processing. Ensuring all parts of the application are filled out as required based on the chosen license type is the first critical step.

  • Using the correct ink color and uppercase letters enhances the readability of the application, avoiding delays in processing.

  • Submitting the Combined Check Worksheet with payment for multiple applications helps the processing team accurately apply payments, preventing financial errors.

  • Providing detailed and verifiable work experience, particularly for Class B licenses, validates an applicant's qualifications and supports their application.

  • Using paper clips instead of staples to fasten the application and attachments prevents damage to the documents, ensuring they can be processed without issue.

  • Signing and dating the application is a critical final step in the submission process, officially completing the application for review.

  • Keeping informed about state reciprocity agreements can provide applicants with crucial opportunities for license reciprocity, simplifying the licensing process.

Documents used along the form

When applying for an Iowa Electrician License, several additional forms and documents often accompany the main application form to ensure compliance with the state's requirements. Each of these documents serves a specific purpose in the application process and helps the Iowa State Electrical Board to assess the qualifications and background of the applicants more thoroughly. Here, we briefly describe four such documents often used along with the Iowa Electrician License Application form.

  • Certificate of Responsible Licensed Master Electricpossiblele: This document is necessary for those applying for an Electrical Contractor license. It identifies the Master Electrician who will act responsiblrunningle the operations of the applying electrical contractor. This certification acts as a pledge that all electrical work will comply with state regulations and standards.
  • Class B Affidavit Form: This affidavit verifies the applicant's experience working as an electrician on or before a specified year, which is crucial for those applying for a Class B license. It requires notarization, underscoring the importance of the accuracy and truthfulness of the applicant's claims regarding their work history.
  • Combined Check Worksheet: When a single check is used to pay for multiple applications, this form is necessary to itemize each application fee included in the total payment. It helps the department manage financial transactions more efficiently and ensures that fees are correctly applied to each applicant's file.
  • Proof of Work Experience: Applicants seeking a license based on their work experience, especially for a Class B license, need to submit detailed documentation of their work history. This includes information about employers, types of duties performed, and durations of employment, providing a comprehensive overview of the applicant's practical experience.

These documents play essential roles in the licensing process, aiding both the applicants and the licensing board. The Certificate of Responsible Licensed Master and the Class B Affidavit Form ensure that applicants meet specific leadership and experience criteria, respectively. The Combined Check Worksheet and Proof of Work Experience streamline the application's financial and experiential verification aspects. Together, they contribute to a transparent and effective licensing process, facilitating the entry of qualified electricians into Iowa's workforce.

Similar forms

The Contractor Registration Application form, required for anyone seeking to be a registered contractor in Iowa, bears similarities to the Iowa Electrician License Application form. Both forms necessitate personal and business information, including contact details and social security or federal tax ID numbers, to ensure proper identification and accountability. Each form requires specific qualifications pertinent to the field, aimed at verifying the applicant's capability and experience. Also, like the electrician license application, the contractor registration mandates the declaration of a responsible party or representative, aligning with the necessity of having a responsible master electrician for electrical contractor applicants.

Professional License Application forms, utilized across various professions, such as medical, engineering, or teaching fields, share foundational characteristics with the electrician license application. These documents systematically collect personal data, educational background, proof of practical experience, and often require the passage of a relevant examination. The inclusion of screening questions to identify any issues that might affect the professional's reliability mirrors the Iowa Electrician License Application's intent to ensure only qualified individuals are granted licensure. Additionally, both forms emphasize adherence to regulatory and ethical standards within their respective professions.

Building Permit Applications, necessary for construction or renovation projects within jurisdictions, align with the Electrician License Application in their foundational purpose of ensuring safety and compliance with local codes and regulations. Both applications gather detailed information on the project or the applicant's qualifications, expecting clear plans or proof of expertise. Importantly, each underscores the need for responsible oversight, whether by a licensed contractor for building projects or a master electrician for electrical works, to guarantee the project meets all standards and ordinances.

The Journeyman Electrician License Application, while more specialized than the general electrician application, presents similar requirements. It demands detailed personal information, verified work experience in the electrical field, and evidence of requisite training or education. Both applications serve the purpose of certifying the competence of electrical professionals, ensuring they are well-equipped with the knowledge and experience necessary for safe and efficient work within their field. The journeyman application, much like the broader electrician license, underscores the value of practical experience and formal education or training.

The Master Electrician License Application parallels the Iowa Electrician License Application through its stringent requirements for extensive experience and in-depth knowledge in the field of electrical work. This form asks for comprehensive personal details, evidence of previous licensing, proof of significant work experience, and often a demonstration of leadership or supervisory capabilities, reflecting the higher level of responsibility assumed by master electricians. Both applications highlight the importance of safety, expertise, and ethical practice in the electrical industry to protect the public and ensure high-quality work.

Dos and Don'ts

When filling out the Iowa Electrician License Application form, it's important to follow the instructions carefully to ensure a smooth process. Here are things you should and shouldn't do:

  • Do ensure that all information is typed or clearly printed in black or blue ink using upper case letters.
  • Do use plain, single-sided 8½" x 11" paper for your application and all attachments.
  • Do fasten all pages together with a paper clip, placing the check or money order on top.
  • Do complete and submit a Combined Check Worksheet if using one check to pay for multiple applications.
  • Do check the specific portions of the license application required for the type of license you are applying for.
  • Do keep a copy of the completed application, all attachments, and your check for your records.
  • Do read the statement at the bottom of the application carefully before signing.
  • Don't use staples to fasten your application and attachments.
  • Don't omit any required sections or fail to provide qualifications for the type of license desired.
  • Don't submit your application or attachments on anything other than the specified paper size.
  • Don't leave the practical electrical work experience section blank if you're applying for a Class B license.
  • Don't forget to provide contact information for three references, preferably in the electrical industry.
  • Don't submit the form without ensuring all licenses in force are listed and active.
  • Don't provide false information, as it may result in the revocation of your license and administrative penalties.

Misconceptions

Misconceptions about the Iowa Electrician License Application process can lead to delays and complications in obtaining licensure. Here, we aim to clarify some common misunderstandings.

  • Misconception 1: Reciprocity Agreements Allow for Automatic License Transfer.

    Many applicants mistakenly believe that a reciprocity agreement with other states means they can automatically transfer their license to Iowa without fulfilling the state's specific requirements. However, Iowa does not currently have reciprocity agreements for electricians with any other state. Applicants must meet all of Iowa's criteria and cannot bypass this process through reciprocity.

  • Misconception 2: All License Types Require the Same Application Items.

    The application process varies significantly depending on the type of electrical license desired. The Iowa State Electrical Board provides a matrix in the application instructions, indicating which sections of the form are relevant to each license type. It is crucial to review this matrix carefully to ensure you complete the necessary portions for your specific license type.

  • Misconception 3: Work Experience Can Only Be Verified by Employers.

    While employer verification is a common way to validate work experience, the Iowa Electrician License Application form also allows self-employed individuals to document their experience. In such cases, the applicant must list their business name and indicate they are self-employed. This provision ensures that independent contractors can also meet the work experience requirements for licensure.

  • Misconception 4: Submission of Documents Not Required for Completion.

    Some applicants mistakenly submit all possible documentation, even those not relevant to their application, believing it might aid their application. However, the instructions explicitly state to not submit forms not required for your application. This measure is intended to streamline the review process and expedite application processing. It’s important to only include documents pertinent to your application to avoid unnecessary delays.

Understanding these misconceptions is vital for a smooth application process. Applicants are encouraged to carefully read and follow the instructions provided by the Iowa State Electrical Board to ensure their application is complete and processed without unnecessary delay.

Key takeaways

When applying for an electrician's license in Iowa, it's essential to familiarize yourself with the process to ensure a smooth submission. Here are five key takeaways that applicants need to remember:

  • Complete and Sign the Application: The application must be thoroughly filled out and signed by the applicant. Incomplete applications will not be processed, delaying licensure.
  • Use Black or Blue Ink and Plain Paper: All information must be typed or clearly printed in black or blue ink, and submissions should be on single-sided, 8½" x 11" plain paper. This requirement helps in maintaining clarity and uniformity in documentation.
  • Submission Method: Use a paper clip, not staples, to fasten all pages together. Include payment on top. If paying for multiple applications with one check, a Combined Check Worksheet must accompany the applications.
  • Provide Required Documentation: Depending on the license type desired (Electrical Contractor, Master Electrician, Journeyman, etc.), applicants need to fill out specific portions of the form as indicated by the accompanying matrix. It's imperative to carefully review which sections apply to your desired license classification to avoid submission errors.
  • Proof of Work Experience and Education: All applicants must supply detailed information about their educational background and work experience relevant to the electrical field. This information plays a crucial role in determining eligibility for the desired license.

Remember, accuracy and honesty in your application are paramount. Providing false information or failing to provide essential documents could lead to delays, denial, or revocation of licensure. Additionally, ensure that all required sections are completed to reflect your qualifications for the type of license you are seeking. Missteps in the application process can be avoided by careful adherence to the guidelines provided by the Iowa State Electrical Board.

Please rate Printable Iowa Electrician License Application Form in PDF Form
4.74
(Incredible)
239 Votes

More PDF Documents