Get In State Form 45703 2014

This guide provides a clear and comprehensive method for completing the Indiana State Form 45703 online. It is essential for those seeking licensure as a radon tester or mitigator in Indiana to follow these steps to ensure a successful application process.

Follow the steps to complete the form accurately and efficiently.

1. Click the ‘Get Form’ button to access the application form and open it in the form editor. Ensure that you have a compatible device for a smooth experience.
2. Begin by filling out the 'Type of License Desired' section. Check all applicable boxes for the different types of radon licenses you are applying for, such as 'Radon Laboratory Tester', 'Secondary Radon Tester', 'Primary Radon Tester', or 'Radon Mitigator'. Ensure you are aware of the associated fees, which are $100.00 for each license type.
3. Proceed to complete the 'Individual Information' section. Enter your last name, first name, middle initial, date of birth, gender, height, weight, and contact information, including home telephone number and email address. Remember to fill in the address where the license should be sent, including city, state, and ZIP code.
4. If you are applying for certain types of licenses, provide the necessary National Radon Proficiency Program (NRPP) Information by filling in your NRPP ID numbers relevant to residential measurement, analytical measurement, and residential mitigation if applicable. Be sure to enclose copies of your current NRPP Certification and Device Performance Test Report Listing Letter if required.
5. If you are applying for re-licensing, follow the instructions for proving your ongoing education. Include proof of your current NRPP Certification and previously held Indiana License Numbers if renewing.
6. On the signature page, review the certifications and protocols you must adhere to. Make sure to sign and date the application to confirm your agreement and accuracy of information provided.
7. Once you have completed all sections accurately, save your changes. You may download, print, or share the completed form as required for submission. Ensure you send it to the Cashier’s Office of the Indiana State Department of Health at the specified address.

Begin your application process today by completing the Indiana State Form 45703 online.