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This guide provides user-friendly instructions for completing the application for a certificate of authority to install, maintain, or service boilers. Following these steps will ensure that you provide all necessary information to support your application effectively.

Follow the steps to successfully complete your application.

1. Click the ‘Get Form’ button to obtain the form and open it in your editor.
2. Enter the company name in the designated field provided at the top of the form. Ensure that the name reflects the legal business name.
3. Provide the company phone number in the area marked. This should be a direct line to the company's primary contact.
4. Input the complete company address, including street, city, state, and zip code, in the respective fields.
5. Include the company email address. This should be a valid email that can receive correspondence regarding the application.
6. Fill in the qualified person's name along with their phone number and full address. This individual is responsible for the application and must provide verification of qualifications.
7. Ensure that all required documentation and a fee of $50.00 are prepared. This includes the citizenship affidavit form GID-276-EN and documentation showing types of boilers and relevant training or experience.
8. For qualifiers, provide information detailing experience, including the names of companies worked for, types of boilers handled, and relevant dates.
9. List the certificate applied for. This section requires you to specify the kind of authority you seek.
10. Indicate the type of boilers that you will be installing, maintaining, or servicing. Check all applicable options.
11. Sign and date the application at the bottom to validate your submission.
12. Once all information is completed, you may save the changes, download, print, or share the form as needed.

Submit your completed application online to ensure a smooth processing experience.