Cosmetology - Sole Proprietor/Partnership Salon Owner Original License


Use and Occupancy Attestation:

A Use and Occupancy permit must be obtained from the local zoning board prior to completing this application.

Your application will not be processed without the Use and Occupancy permit. The Use and Occupancy Permit must be sent to the Board of Cosmetology within 10 days of submitting this application. If the permit is not received by the Board within 10 days, your application will be denied.

The permit must be sent to The State Board of Cosmetology, 1100 N. Eutaw St, Baltimore, MD 21201

Have you obtained the Use and Occupancy Permit? Yes
  Date of Permit: - - (MM-DD-YYYY)
  Permit Number:

Personal Information:

Enter license type:

Full Service: A Full Service Salon is authorized to offer all cosmetology services

Limited Service: A Limited Practice Salon is authorized to offer only esthetics or manicuring services.


Enter business type: Sole Proprietor or Partnership

Sole Proprietor or
Partner #1 Name:
First Middle
Last
Partner #2 Name: First Middle
Last

The following personal information should be for the sole proprietor or partner #1:

I have a United States mailing address
Address:
City, State Zip: , -
County:
I have a mailing address outside the United States
Address:

Social Security Number:
Date of Birth (MM-DD-YYYY): - -
Place of Birth:
I was born in the United States
  City and State: ,
I was born outside the United States
  City and Country:
Gender:         Male Female
Home Phone Number: - -
E-mail Address:

Business Information:

Note: If you change the name of your salon, the outside signage of the business must be changed to match the salon's name. If the names do not match, you are in violation of the Cosmetology Regulations. If the address below is no longer valid , please exit this application and apply for an original salon/shop permit.

Salon Name/Outside Signage:
Salon Address:
City, State Zip: , -
County of Salon Address:
Business Phone No.: - -

Required Information:

Have you ever:
1. Been convicted of a felony or misdemeanor in any State or Federal Court? Yes No
2. Had this type of license, certificate, registration, or permit denied, suspended, or revoked by Maryland or any other jurisdiction? Yes No

Workers Compensation:

 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:



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