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Elevator Work Experience Verification Form

Elevator Work Experience Verification Form 2026

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The document is a Work Experience Verification Form from the Minnesota Department of Labor and Industry, specifically for elevator licensing applicants. It outlines the requirements for verifying employment and work experience necessary for licensure in various elevator-related classifications. The form must be completed by employers, detailing the applicant's work history, hours worked, and specific classes of work performed. It emphasizes the importance of accurate reporting and provides guidelines for both licensed and unlicensed individuals seeking to qualify for examinations.

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Click ‘Get Form’ to open the Elevator Work Experience Verification Form in the editor.
Begin by entering your legal name and, if applicable, your license or registration number. Ensure that you print clearly or type this information.
Provide the last four digits of your Social Security Number and select your license type from the options available.
Fill in the employer's details, including their name, address, phone number, and email. This section is crucial for verifying your work experience.
Indicate your dates of employment by entering both the start and end dates. Be precise with these dates as they are essential for verification.
Report the hours worked in each class of work performed during your employment period. Ensure that these hours do not exceed the maximum allowed.
Finally, both you and the responsible individual must sign and date the form to certify its accuracy before submission.

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Versions	Form popularity	Fillable & printable
2016	4.8 Satisfied (36 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What does an elevator certificate look like?

they usually in a form of regular A4-size paper, card or a sticker. For elevators, they are normally displayed inside the elevator car, either displayed on the elevator wall or hidden behind a cabinet. For escalators, they are normally displayed near the escalators entrances.

Is cat 5 testing and 5 year load testing the same thing?

Depending on the type of device, some also require a Category 5 full load inspection test every five years. Category 5 tests are due at the end of the month in which they were last performed. For example, if a Category 5 report was last filed in March 2012, it would be due again at the end of March 2017.

How much does a cat 5 elevator test cost?

Category 1 Annual Inspection: $150/month. Affirmation of Correction: $150/month. Category 5 Inspection: $250/month.

What are the requirements for an elevator?

To be ADA compliant, an elevator must meet minimum the following dimensions: The minimum door width for an elevator car is 36 inches. The depth of the car must be at least 51 inches, The width of the car must be at least 68 inches. Elevators with center-opening doors must have a width of at least 80 inches.

What is an experience verification letter?

An employment verification letter is used to prove that someone is currently or was previously employed at a company. These letters are often used to verify employment for lenders, or when someone needs to prove their residency, a specific skill, or that theyve worked for a specific employer.

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What is a CAT 5 test for elevators?

CAT-5 Full Load Test This test is designed to ensure that the elevator car and all of its components are able to safely handle the maximum load that they will be expected to carry.

What is cat 5 testing?

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Elevator Work Experience Verification Form 2026

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