Architect - Original Corporate / Partnership / LLC / LLP Permit


CorporationPartnershipLLPLLC
This application is for a:

The following individual is an officer, partner, or member duly licensed to practice architecture and who shall be in responsible charge of the practice of architecture in this state through this Corporation / Partnership / LLP / LLC:
Title:
License Number:
Social Security Number:
(for verification purposes only)

President/Partner Name:

Resident Agent Name::
Address:
City, State Zip: , -

Corp./Partnership/LLC/LLP Name:
Business Address:
City, State Zip: , -
County of Business Address:
Contact Phone No.: - -
Contact Person Email Address:

Federal ID:
For Corporation/LLC Only: Name of State in which incorporated and date of Certificate of incorporation.
State: Date: --

 I have Workers Compensation Coverage   Policy/Binder No.

Issued by the  

 I am not an employer required to provide employee coverage under the Workers Compensation Law.


Certification

By pressing "Submit" below:

    I hereby certify, under penalty of perjury, that the information contained herein is true and correct to the best of my knowledge, information, and belief. I further authorize the release of any information contained within this application to an authorized representative of the Department of Labor, Licensing and Regulation for further investigation. I further certify that I have paid all undisputed taxes and unemployment insurance contributions payable to the Comptroller or the Department of Labor, Licensing and Regulation or have provided for payment in a manner satisfactory to the unit responsible for collection.

    I affirm that I have carefully read the laws and regulations set forth in Title 3, Business Occupations and Professions Article, Annotated Code of Maryland, and the Code of Maryland Regulations, Title 09, Subtitle 21. I further affirm that I understand and accept my responsibilities under such laws and regulations.

    Also, I understand that at least two-thirds of the directors (corporations), partners (partnerships), general partners (LPs) or members (LLCs) must be licensed in Maryland or another state to practice architecture, engineering, or landscape architecture and that this composition must be maintained at all times in order to remain in compliance with the Maryland Architects Act, Business Occupations and Professional Article 3-404.



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