THE STATE
MATTHEW H. MEAD
OF WYOMING
Department Of Fire Prevention & Electrical Safety J. MICHAEL REED
state fire marshal
governor
RECIPROCAL INFORMATION Anyone who has tested and failed for a Master or Journeyman electrical license, within the state of Wyoming, is not eligible for a reciprocal license until they have held a license from their primary state for a period of three (3) years and must show proof of an approved continuing education seminar of sixteen (16) hours on electrical code which is currently enforced in the State of Wyoming. Licenses that have been grandfathered in are not eligible to be reciprocated. The State of Wyoming is Reciprocal with the Journeyman Electrician License in the following states: ARKANSAS SOUTH DAKOTA OREGON TEXAS NEBRASKA UTAH MAINE OKLAHOMA
COLORADO NEW HAMPSHIRE MINNESOTA IDAHO MONTANA NEW MEXICO ALASKA NORTH DAKOTA
To receive a reciprocal journeyman license, you must have obtained your license by examination with a score of 70% or more on the state exam from the reciprocating state, and have held your license for at least one year. We will need to receive an application form signed and notarized, along with a copy of your license and a check or money order made out to the “State of Wyoming” for $100.00. The State of Wyoming is Reciprocal with Master Electrician License in the following states: IDAHO, SOUTH DAKOTA & UTAH To receive a reciprocal master license, you must have obtained your license by examination, received a score of 75% or better and have held your license for at least one year. We will need to receive an application form signed and notarized, along with a copy of your license and a check or money order made out to the “State of Wyoming” for $200.00. If you have any questions regarding the reciprocal license, please give our office a call at (307) 7777288. Please send all applications with the appropriate fees to: Department of Fire Prevention & Electrical Safety Electrical Licensing 320 West 25th St., 3rd Floor Capitol Hill Building Cheyenne, WY 82002
Revised: 08/13/2014
State of Wyoming – Electrical Board Application for Reciprocal Electrician’s License (Lines marked * are required) ~This application must be filled out completely and in detail~ * Designate the type of license for which you are applying: Master Electrician
Journeyman Electrician
Note: Journeymen and Masters must have received the license by examination and have held that license for a year or more. A copy of the license must also be included with this application. Masters are only reciprocal with South Dakota, Utah and Idaho. * Designate the state from which you would like to reciprocate: (Please choose only one state.) Arkansas S. Dakota Idaho
Colorado Minnesota Oregon
Montana Texas Maine
Utah Nebraska Alaska
New Hampshire New Mexico _______Oklahoma
Personal Information: *Name:
License # First, Middle, Last *SS#:
-
-
*D.O.B: MM/DD/YYYY
Address Information: * Mailing Address: * City:
* State:
* Zip:
State:
Zip:
Physical Address: (If different from mailing address) City:
Contact Information: Home Phone #:
(
)
-
Business #:
(
)
-
Cell or Daytime #: (
)
-
Fax #:
(
)
-
Phone #: (
)
-
Email Address:
Employment Information: Present Employer: Employer Address:
City/State/Zip:
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SFMO 04/01/2011
* State the type or grade of electrical license you have: * License Number: In force from
* From what state?: To
* Was this license obtained by examination? YES
* Have you ever had an electrical license revoked or denied by this or any other state?
YES
NO
NO
*If “YES”, attach a detailed statement explaining who revoked or denied the license and why. *Have you ever held an apprentice, journeyman, master or any other type of Wyoming license?
YES
NO
*If “Yes” what type of license was it? _______________________________________________________ *If your license is no longer active, when did it expire? *If you previously had a Wyoming license, was the licensed received by? Exam __________
Reciprocation__________ Apprenticeship __________
Remarks by Applicant
APPLICATIONS WILL NOT BE PROCESSED UNLESS COMPLETELY FILLED OUT, SIGNED, NOTARIZED AND ACCOMPANIED BY THE APPROPRIATE FEES. PLEASE MAKE CHECKS, MONEY ORDERS OR CASHIER’S CHECKS PAYABLE TO THE STATE OF WYOMING AND MAIL THEM WITH THE COMPLETED APPLICATION TO:
Department of Fire Prevention & Electrical Safety Attn: Electrical Licensing 320 West 25th St., 3rd Floor Capitol Hill Building Cheyenne, WY 82002
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~This Application Must Be Signed And Verified~ I,
, swear upon oath that the following facts are true:
1.
I have applied for a Wyoming Reciprocal license. I acknowledge receipt of the Wyoming Electrical Board Rules and Regulations. I have read the materials submitted in my application. I know and understand the contents thereof.
2.
The information submitted in my application is true and accurate.
3.
I understand that the State Chief Electrical Inspector may verify my qualifications as stated in W.S. 35-9122.
4.
As described in W.S. 35-9-130, untrue or inaccurate statements in my application may constitute grounds for revocation or forfeiture of my license and/or filing of criminal charges against me and those who assisted me in submitting false information.
* Signature
State of:
Date
This section is to be completed by a Notary Public County of:
The foregoing instrument was acknowledged before me by: This
day of
20
. (seal)
Notary Public My commission expires:
Space Below Reserved Office Use Only Approved for Reciprocal License: Rejected:
Date:
Date: Reason:
Received By: __________________________________________ Date:______________________________ Fee paid: $________________ ( ) Cash ( ) Check/Money Order Number:________________________ Receipt Number:_________________________
License Number:__________________________
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