Information and requirements for self wiring - North Dakota State 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the applicant's name and address in the designated fields. Ensure accuracy, as this information is crucial for identification.
3. Fill in the name of the electrical contracting business along with its address, city, state, master name, and license number. This section verifies the employer's credentials.
4. Indicate the position held by the applicant and specify the dates of employment. Mark whether the employment was full-time or part-time.
5. Record the total number of hours worked in electrical roles. This is essential for compliance with state regulations.
6. Answer whether the employment dates are taken from payroll records. If not, provide an explanation in the space provided.
7. Confirm if all jobs were inspected by a governmental authority. If any jobs were not inspected, explain why.
8. If any work was completed outside North Dakota, attach a detailed list of those jobs including hours worked and inspection status.
9. Finally, ensure that a master electrician signs in front of a notary public to validate this record before submission.

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