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Plumbing affidavit 2026

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  1. Click ‘Get Form’ to open the plumbing affidavit in the editor.
  2. Begin by entering the name of the owner, authorized contractor representative, or approved training director in the designated field.
  3. Next, input the trainee's name and their training certificate or Social Security Number.
  4. Fill in the company or training program name along with its UBI or license number.
  5. Indicate the dates of employment by selecting the start and end dates from the calendar fields provided.
  6. Specify the supervising plumber’s name and certificate number to ensure proper verification.
  7. Select the category of experience gained (Commercial, Residential, Pump and irrigation, Domestic well) and enter the corresponding hours worked.
  8. Finally, review all entries for accuracy before signing. Ensure that notarization is completed as required.

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20204.8 Satisfied (138 Votes)
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Supervising plumbers name and certificate number are required. I affirm and DocHub that. Printed name of owner, authorized contractor representative orRead more

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860 IAC 1-1-10 - Verification of employment | State Regulations

Sec. 10. (a) An applicant for admission to the plumbing contractor or journeyman plumber examination must submit with the applicants application affidavitsRead more

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