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DLLR2.gif DLLR2.gif
Department of Labor, Licensing and Regulation
500 North Calvert Street
Baltimore, Maryland 21202

DLLR ELECTRONIC LICENSING TECHNICAL SUPPORT FORM

Phone Number e.g. (410-555-1212)
Registration Number e.g. (1234567) Instructions for completing this form
Full Name e.g. (first & last names)
E-mail e.g. (you@wherever.com) @ .
Internet Service Provider e.g. (ISP)
Date Issue Occurred e.g. (mmddyy)
Time Issue Occurred e.g. (hhmm)
Description of Issue