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Personal Information
Are you under a court or administrative order to pay child support?
Have you ever been convicted or pled guilty to an offense anywhere (an offense is defined as a violation, misdemeanor or felony)?
Do you owe any penalties to the City of New York?
Does any company or business you have been associated with under your Department-issued license owe any fines, penalties or fees to the City of New York that were incurred during your association with that company or business?
Have any licenses or privileges granted to you or your associated businesses by the department of buildings or any other government entity ever been rescinded, revoked, surrendered, suspended, otherwise disciplined, or have you or your related businesses ever been disqualified from performing inspections?
Have any license applications ever been denied to you by the department of buildings or any other government entity?
Are you related to any DOB employees?
Business Information
License Use
Are you a New York City employee?

Licensing Registration Form
 

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