Business Name of Applicant |
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Business Telephone Number |
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Complete Mailing Address |
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Zip Code |
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E-Mail Address |
Web Address |
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4.If the business is a GENERAL PARTNERSHIP, all partners must be listed including full name, address, city, state, zip code, and Social Security or Federal ID number of each partner. If adequate space is not provided to list all general partners, attach an additional sheet listing all others.
If the partnership uses a fictitious name, the fictitious name must be registered with the Business Division (701-328-4284).
If the business is a LIMITED LIABILITY PARTNERSHIP, all managing partners must be listed including full name, address, city, state, zip code, and Social Security or Federal ID number of each managing partner. If adequate space is not provided to list all managing partners, attach an additional sheet listing all others. The limited liability partnership must be registered with the Business Division (701-328-4284).
If the business is a CORPORATION or LIMITED LIABILITY COMPANY it must be registered with the Business Division (701-328-4284) by filing either Articles of Incorporation or Articles of Organization if a domestic organization, or Certificate of Authority if a foreign (out-of-state) organization. If the corporation or limited liability company uses a trade name, the trade name must also be registered.
If the business is a SOLE PROPRIETORSHIP which uses a trade name, the trade name must be registered with the Business Division (701-328-4284).
5. Does the applicant have a North Dakota Sales and Use Tax permit? |
Yes No If yes, provide the number _____________________. |
For information regarding this permit, contact the North Dakota Tax Department at 701-328-1241.
6.North Dakota Century Code, Section 43-07-04 requires an applicant to submit to the Secretary of State a statement from North Dakota Workforce Safety & Insurance that the applicant has secured satisfactory WORKERS COMPENSATION coverage. If you do not have any employees, a verification of nonemployment is required to be filed. For details, contact the Workforce Safety & Insurance, 1600 East Century Avenue Suite 1, Bismarck, North Dakota 58506, (701-328-3800) or (800-777-5033).
7.In compliance with the Federal Privacy Act of 1974, the disclosure of the social security number or Federal ID number on this form is voluntary. They are not disclosed to the public. The numbers are used by the Secretary of State to maintain accurate contractor files. Therefore, while voluntary disclosure is requested, failure to do so will not invalidate this application.
For the purpose of qualifying for a contractor's license, the applicant submits, under oath, the following information:
A. Business Type |
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B. Business Federal ID |
Sole Proprietorship - Complete C Below |
Limited Liability Company - state of origin _________ |
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General Partnership - Complete C & D Below |
Corporation - state of origin _________ |
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Limited Liability Partnership - state of origin __________ |
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Complete C & D Below |
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C. Name of Owner (or General Partner or Managing Partner) |
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Social Security/Federal ID Number |
Home Telephone Number |
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Complete Mailing Address |
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Zip Code |
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D. Name of General Partner (or Managing Partner) |
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Social Security/Federal ID Number |
Home Telephone Number |
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Complete Mailing Address |
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Zip Code |
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8.North Dakota Century Code, Section 43-07-04 requires an applicant to file a CERTIFICATE OF INSURANCE indicating liability coverage as proof that the applicant has secured liability insurance. The certificate holder needs to be: ND Secretary of State, 600 E Blvd. Ave, Dept. 108, Bismarck, ND 58505-0500.
9.In addition to a contractor's license, you may need to obtain other licenses or permits as required by law (e.g. the State Electrical Board, the State Plumbing Board, Transient Merchant License from the Attorney General or Asbestos Abatement from the Health Department).
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