Get Notarized Statement Of Experience Pi-217 - State Of Michigan - Mich

This guide provides step-by-step instructions for completing the Notarized Statement Of Experience PI-217, a critical document for those applying for or renewing pesticide applicator licenses in Michigan. Follow these guidelines carefully to ensure accuracy and compliance.

Follow the steps to effectively fill out your form online.

1. Press the ‘Get Form’ button to access the Notarized Statement Of Experience PI-217 and open it in your preferred document editor.
2. Begin by filling in Section A, which is dedicated to company information. Enter the date, company name, license number (if applicable), address, city, contact person, telephone number, email address, purpose, state, zip code, and county. Be sure to indicate whether you are requesting a new license or adding a new category by checking the appropriate box.
3. In Section B, provide your name and certification number, noting the expiration date. Select the appropriate option regarding your experience, such as having worked multiple seasons or having relevant academic qualifications. Complete Sections C, D, and E based on your selection.
4. Move to Section C to detail your pesticide application experience and education. List the pesticide application equipment you have used, the pesticides you have applied, industry organizations you are a member of, and any relevant workshops or classes that enhance your expertise.
5. Fill out Section D with your qualified pesticide applicator employment history. Provide the business name, address, contact information, dates of employment, and descriptions of your duties for each position where you applied pesticides.
6. In Section E, list your college or university degrees that include pest control elements, and remember to attach a copy of your transcript for verification.
7. Finally, proceed to Section F to sign the statement. Your signature must be notarized, so do not sign until you are in the presence of a notary public. Ensure the notary uses their official seal or rubber stamp.
8. After filling out the form, review all entered information for accuracy. You can then save your changes, download, print, or share the completed form as needed.

Complete your application process online by submitting the Notarized Statement Of Experience PI-217 today.