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Get MN Inactive License Request Form 2012-2024

After issuance of a license all information contained in this application except your Social Security Number will be public information pursuant to Minnesota Statutes Chapter 13. 03/2012 Social Security Number Date of Birth First Name Primary Phone Number Middle Initial / Last Name Residential Address City Current Operator License Number State Zip Code Email Address Newsletters and Renewal Notifications In order to reactivate you must successfully complete a BCE approved refresher course and provide a course complete certificate or certification of skills. Below is a listing of what may be required of you if you choose to return to active status. Current Paid Inactive Status-3 Years or Less o 40 Hour Refresher Course- All Licenses Types Staff Initials o 155 Hour Refresher Course- Cosmetology License I declare under penalty of law that the information supplied on this form is the truth. Board of Cosmetologist Examiners 2829 University Avenue SE Suite 710 Minneapolis MN 55414 651-201-2742 - 612-617-2601 fax www. bceboard. state. mn*us - bce. board state. mn*us Inactive License Request Form -MAKE A COPY OF THIS APPLICATION FOR YOUR RECORDSInstructors are unable to go into Inactive Status You are required to inform the Minnesota Board of Cosmetologist Examiners if you desire to go on inactive status. To apply for inactive status your license must be current and all fees paid* You can mail fax or email with signature the form to the BCE offices. Be sure to include your current license number on this form* Please Check Type of License Cosmetologist Manicurist Esthetician Manicurist Manager School Manager Licensee Information The data which you furnish on this application will be used by the BCE to assess your qualifications for licensure. Disclosure of this information is voluntary. You are not legally required to provide this data however if you fail to do so the BCE may be unable to process this application* Disclosure of your Social Security number is required by Minnesota Statutes 270C. 72 and your Social Security number may be requested by and released to the Minnesota Commissioner of Revenue. Then BCE may use your Social Security Number for revenue recapture as authorized by Minnesota Statutes Chapter 270A. After issuance of a license all information contained in this application except your Social Security Number will be public information pursuant to Minnesota Statutes Chapter 13. 03/2012 Social Security Number Date of Birth First Name Primary Phone Number Middle Initial / Last Name Residential Address City Current Operator License Number State Zip Code Email Address Newsletters and Renewal Notifications In order to reactivate you must successfully complete a BCE approved refresher course and provide a course complete certificate or certification of skills. Below is a listing of what may be required of you if you choose to return to active status. Current Paid Inactive Status-3 Years or Less o 40 Hour Refresher Course- All Licenses Types Staff Initials o 155 Hour Refresher Course- Cosmetology License I declare under penalty of law that the information supplied on this form is the truth. .

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