Get Pea New Application Form - Dol Nebraska

Filling out the PEA New Application Form for a Private Employment Agency license in Nebraska is a crucial step for individuals looking to operate within this industry. This guide provides a clear, step-by-step approach to assist you in completing the form accurately and efficiently online.

Follow the steps to successfully complete your application form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your personal information in the designated fields. This includes your name (last, first, and middle initial), residence address, social security number, date and place of birth, and age.
3. Indicate your citizenship status by selecting either 'Yes' or 'No' when prompted.
4. Provide the name of the corporation under which you will be conducting business, along with the agency address including street, city, state, county, and zip code.
5. Specify the state where the Private Employment Agency is incorporated, and make sure to attach a copy of the articles of incorporation.
6. List all individuals with a financial interest in the agency's business, and note that each must complete a separate application.
7. Enter the name of the individual who will serve as the manager of the agency and provide their details, including date of birth and social security number.
8. Respond to whether you have a financial interest in any other business, and if 'Yes', include the names and addresses of such companies.
9. Document your employment history for the past ten years, detailing your employers, positions held, and duration of employment. If necessary, attach additional sheets.
10. Answer whether you have ever been licensed as an owner, manager, or counselor of a Private Employment Agency and provide any relevant details.
11. Respond to questions regarding any revocations or suspensions of your licenses, previous convictions, or pending charges, providing full explanations as needed.
12. List at least three personal references who have known you for two years, including their names, addresses, and contact information.
13. Finally, sign and date the document, and ensure you have a notary public’s signature.
14. Attach the required documentation, including the license fee, surety bond, sample contract agreement, fee schedule, referral form, job order sample, and articles of incorporation. Then, decide to save, download, print, or share the completed form.

Start your application today by filling out the PEA New Application Form online.