Free Georgia Pe Comity Application Form in PDF

Free Georgia Pe Comity Application Form in PDF

The Georgia PE Comity Application form is a crucial document for engineers seeking to practice professionally in Georgia through the principle of comity, also known as reciprocity. This approach allows engineers who are already licensed in another state to obtain a license in Georgia, contingent upon meeting specific requirements laid out by the Georgia State Board of Professional Engineers & Land Surveyors. For those looking to expand their professional practice into Georgia, filling out the Georgia PE Comity Application accurately is a vital step. To begin your application, click the button below.

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The journey to becoming a recognized professional engineer in Georgia involves navigating through various procedural steps, one of which includes completing the Georgia PE Comity Application form. This meticulous document, overseen by the Georgia State Board of Professional Engineers & Land Surveyors, facilitates the certification of engineers seeking licensure across state lines through comity, or reciprocity. With an application fee set at $70, which is non-refundable, the form caters to engineers who already hold a Professional Engineer license in another state and wish to extend their professional practice to Georgia. Applicants are required to provide detailed personal and professional information, including existing licensures, educational background, and engineering experience. The form emphasizes the necessity of an NCEES Record for those who hold one, streamlining the validation process of an applicant’s credentials by eliminating the need for separate submissions of endorsements, licensure verifications, or transcripts. This thorough application also probes into the applicant's legal background, asking for disclosures concerning any past convictions, licensure sanctions, or professional misconduct, ensuring that only candidates of proven integrity and professionalism are granted licensure. Ultimately, the Georgia PE Comity Application form signifies a critical step for seasoned engineers aiming to broaden their horizons and embrace new opportunities within the state of Georgia.

Preview - Georgia Pe Comity Application Form

GEORGIA STATE BOARD OF PROFESSIONAL ENGINEERS & LAND SURVEYORS

237Coliseum Drive • Macon, Georgia 31217 • (478) 207-2440 www.sos.ga.gov/plb/pels/

APPLICATION FOR CERTIFICATE AS A PROFESSIONAL ENGINEER

Application Fee $70 (non-refundable)

License Type: PROFESSIONAL ENGINEER

Additional License Types (currently or previously issued by the Georgia Professional Licensing Boards): ___________________________________

Method Obtained by: Applicant is applying for above referenced license by: Comity Original PE license from the State of _______________

Name as desired on License (First, Middle, Last, Suffix): ________________________________

Name as shown on exam records or transcripts (First, Middle, Last, Suffix):

(if different) _____________________________________

Social Security Number: ____ -____-_______ Date of Birth: ___/___/_____

Physical Address: # Street __________________ Apt/Ste: ______ City: ______ State ___ Zip _____

P.O. Box not acceptable for Physical Address

Mailing Address: # Street __________________ Apt/Ste: ______ City: ______ State ___ Zip _____

(if different)

Telephone Day: (____) ____- _____ Telephone Evening: (____) ____-_____

E-Mail Address: __________________________

Affiliation:

Name of firm: __________________________________________

Physical Address: # Street __________________ Apt/Ste: ______ City: ______ State ___ Zip _____

P.O. Box not acceptable

Mailing Address: # Street __________________ Apt/Ste: ______ City: ______ State ___ Zip _____

(if different)

NOTE TO APPLICANT: This information will be entered into the Division database for Accounting and Licensing purposes. All items must be completed, and then duplicated on the next page of the application for Board review.

APPLICATION FOR REGISTRATION AS A PROFESSIONAL ENGINEER BY COMITY

Note: NCEES Record Holders are required to completely fill out sections 1 through 5. NCEES Record Holders are not required to submit endorsements, verification of licensure/exams or transcripts as those items are part of the NCEES Record.

Section 1: General Information

Date: ____________________

 

 

Name (First, Middle, Last, Suffix): ___________________________________________________________

 

Home Address: # Street __________________ Apt/Ste: ______ City: ______ State ___ Zip _____

 

Preferred address: # Street __________________ Apt/Ste: ______ City: ______ State ___ Zip _____

 

Social Security Number: ____-___-_____ Birthplace: ________________ Date of Birth: ___/___/_____

 

Business Phone: (_____)_____ - ______________ Home Phone

(_____) _____ - ________________

 

 

 

 

Have you ever been convicted or pled nolo contender, pled guilty, or been given first offender status for

 

 

any offense status for any offense which is a felony, misdemeanor, a crime violating a federal law

Yes

No

involving controlled substance or dangerous drug, or a DUI or DWI? If yes, provide documentation.

 

 

Have you ever had a licensed that was revoked, suspended, restricted, probated, or surrendered to any

 

 

licensing board or agency? If yes, provide documentation.

 

Yes

No

Have you ever been found liable in civil court of any misconduct, fraud, or negligence in the practice of

 

 

engineering or land surveying? If yes, provide documentation.

 

Yes

No

Has any professional license granted to you been revoked, suspended or otherwise sanctioned publicly

 

 

or privately, or have you ever been denied license, by any board or agency in Georgia or any other

Yes

No

state? If yes, provide documentation.

 

 

 

Do you hold a current NCEES Record that you plan to submit? If yes, contact NCEES for record to be

 

 

sent electronically to the GA Board and complete all of sections 1 through 5 of this application.

Yes

No

Are you currently registered as a Professional Engineer in the state where you live?

 

 

If no, why not? _________________________________________________

Yes

No

 

 

 

 

Has your name changed since birth?

 

 

 

If yes, why? ____________________________________________________

Yes

No

 

 

 

 

Have you ever applied to this Board for registration before?

 

 

 

If yes list when and what type of application _________________________________________

Yes

No

 

 

 

 

Which one branch of engineering do you propose to practice in the state of Georgia? _________________

Designate the special branches of engineering in which you have been examined: ___________________

Present Employer __________________________________________ Position: ___________________

Note: It is the Board’s policy for Comity applicants who practice or propose to practice Structural Engineering and have taken the PE exam in a discipline other than Structural, to have a minimum of 60 months of Structural engineering experience after successful examination acceptable to the Board at the time of application.

Revised 07-12

Section 2: Registration

PE COMITY

EIT-State ____________ Certificate No ____________

Date of Certification as EIT: ___/___/_______

Number of hours written exam (“0” if no written examination taken): ______

PE-State _____________ Certificate No ____________

Date of first registration as a PE ____/____/________

If registered by written exam, indicate number of hours for the exam (“0” if no exam taken): ____

Indicate exam options taken: _______________________

List all states in which you are currently registered as a PE: _______,_______,_______,_______,_______

List other states and types of registration for which you have applied or are currently applying but do not have final notification of registration: _______,_______,_______,_______

NOTE: If you hold an NCEES Council Record and plan to submit it in lieu of endorsements, verification of licensure/exam and transcripts, then you should completely fill out Sections 1 through 5 of this application and contact NCEES to have them electronically transmit your NCEES record to the Georgia Board for consideration. For further information regarding an NCEES Council Record, please contact NCEES at www.ncees.org or 1-800- 250-1396.

NOTE: If you do not hold an NCEES Council Record, you will need to bundle and send with your application:

Official transcripts for each college attended, whether you graduated or not

Evaluation of foreign degree (if you earned your bachelor’s degree outside the US) from an approved provider. If you choose not to have an evaluation, you will need to send a letter indicating so.

Verification of original exam/licensure of both the EIT and PE, and if different, verification of licensure from the state where you live now. If you are not licensed in your residence state, indicate in Section 1.

Endorsements for all experience you list in Section 3. You must have at least five endorsements/references from five (5) individuals, three (3) of which must be currently active PE’s, that are not related to you by

blood or marriage, are not Board members and who have personal knowledge of your engineering experience, reputation and accomplishments.

All of the above supporting documentation must be sent to the Board in sealed envelopes, with the back flap signed to ensure no tampering. Some states/agencies/individuals prefer to send their documentation directly to the Board, which is permissible. This information will be maintained at the Board office and added to the application file upon receipt.

NOTE: Be sure to sign your application and have your signature notarized (Section 5.)

 

Board Use Only Section:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

School______________________________________

Degree/Date____________________________Abet Yes_________No__________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Masters_____________________________________

Degree/Date____________________________Abet Yes_________ No__________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Technology__________________________________

Degree/Date____________________________ Abet Yes_________No__________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other_______________________________________

Degree/Date____________________________ Abet Yes_________No__________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EIT/Date Obtained___________ _________ PE/Date Obtained____________________Discipline__________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 3: Engineering Experience

 

 

 

 

 

 

 

 

 

 

 

PE COMITY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Engmt

 

 

 

 

Part

From

To

Total

 

%

 

 

Qex

 

%

 

 

Qex

 

%

 

 

Qex

 

 

%

 

 

Qex

 

%

 

 

Qex

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

#

Company Name

Your Title

 

Time?

mm/yy

mm/yy

Months

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL NUMBER OF ENDORSEMENTS FORMS: _______

 

 

 

 

 

 

 

 

 

 

Education Total

 

 

 

 

 

 

NCEES Record Requested in lieu of endorsements Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Field:

 

 

 

 

Experience Total

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References: Positive

(

)

 

 

Total Months

 

 

 

 

 

 

Negative

(

)

 

 

 

 

 

 

 

 

 

Special:

 

 

 

 

Board Member’s Initials

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Shaded areas are for Board use only

 

 

 

 

 

 

 

Note: List all engagements of engineering experience beginning with the earliest and ending with your current position. Endorsement form (Section 6) should correspond with this section. All engagements listed must be described on an endorsement form and someone familiar with your work (preferably your supervisor) should endorse it.

Section 4: Education

 

 

 

 

PE COMITY

 

 

 

 

 

 

 

INSTITUTION AND LOCATION

FROM

TO

Date of

 

 

 

 

 

 

 

 

 

 

 

 

 

Mo/Yr

Mo/Yr

Graduation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

High Schools: (Transcripts not needed)

 

 

 

 

 

 

 

 

 

 

 

 

1.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

 

 

 

 

 

 

 

 

 

 

 

 

 

Colleges and Universities: (Transcripts

needed from all schools ever attended listed unless applicant is submitting NCEES record)

FROM

Mo/Yr

TO

Mo/Yr

TOTAL MONTHS

MAJOR FIELD

DEGREE EARNED

1.

2.

3.

4.

5.

Section 5: Affidavit by Applicant

I hereby swear and affirm that all information provided in this application is true and correct to the best of my knowledge and belief. I further swear and affirm that I have read and understand the current state laws and rules and regulations of the Georgia State Board of Registration for Professional Engineers and Land Surveyors, and I agree to abide by these laws and rules, as amended from time to time.

By signing this application, electronically or otherwise, I hereby swear and affirm one of the following to be true and accurate pursuant to O.C.G.A. § 50-36-1:

1)_______I am a United States citizen 18 years of age or older. Please submit a copy of your current Secure and Verifiable Document(s) such as driver’s license, passport, or other document as indicated on page 12 of the application.

2)_______I am not a United States citizen, but I am a legal permanent resident of the United States 18 years of age or older, or I am a qualified alien or non-immigrant under the Federal Immigration and Nationality Act 18 years of age or older with an alien number issued by the Department of Homeland Security or other federal immigration agency. Please submit a copy of your current immigration document(s) which includes either your Alien number or your I-94 number and, if needed, SEVIS number.

In making the above attestation, I understand that any failure to make full and accurate disclosures may result in disciplinary action by the Georgia State Board of Registration for Professional Engineers and Land Surveyors and/or criminal prosecution.

State of _________, County of ______________Applicant's Signature_______________________________

Subscribed and sworn to before me this_________day of _____________ , 20______

___________________________________________________(SEAL)

Signature of Notary Public

My commission expires:________/_______/_________

NON-ENGINEERING AND RELATED GAPS

PE COMITY

PLEASE LIST (references not needed)

 

Applicant Name: ____________________________________________

 

If no gap information is needed to be entered, check here:

 

From _______________To ______________

Description ___________________________________________________

From _______________To ______________

Description ___________________________________________________

From _______________To ______________

Description ___________________________________________________

From _______________

To ______________

Description

___________________________________________________

 

 

From _______________

To ______________

Description

___________________________________________________

 

 

 

This is page 1 of a two-page form. Please return both pages stapled together.

PE COMITY

Section 6: Endorsement Form

 

SECTION 6-A (TO BE COMPLETED BY APPLICANT)

 

Name: __________________________________________________________

 

Engagement # as listed in Section 3: _______ Social Security Number_____-____-___________

 

This endorsement is for: Reference & Experience Verification

Reference Only

Experience Verification Only

GA Law Section 43-15-15(d) states: “An application shall contain the names of not less than five persons, not related to the applicant by blood or marriage, of whom at least three shall be registered, active professional engineers…having personal knowledge of the experience on which the applicant predicates his qualifications.”

Experience described on this form was obtained while employed by (company name): ___________________________

Street Address: _____________________________ City: _______________ State: ________ Zip: _________

For this engagement, please provide name of direct supervisor: ___________________________________________

Was your direct supervisor a registered PE? Yes

No

Other: ___________________________________________

Endorser for this engagement: _____________________________________________

State your title(s) & Name of Company. Describe experience (one line is not sufficient) detailing in first person the work you personally performed in design, study, review, testing or other tasks which required your engineering skills. This work should be progressive in difficulty and magnitude; demonstrate sufficient breadth and scope, not a narrow technical skill focus; and reflect the acquired ability to design and apply engineering principles to demonstrate that your judgment may be trusted on projects involving public health and safety. Do not attach resume or project lists. Experience must be verified by PE associates even if you are self-employed.

 

 

Dates

 

Engagement

 

 

 

 

#:

 

From

 

To

 

 

Mo/Yr

 

Mo/Yr

 

___/_____

 

___/_____

 

 

Type of Experience

%

 

 

 

Engineering Design

 

 

 

 

Engineering Studies, Reports, Evaluations

 

 

 

Engineering Research, Data Preparation &

 

Interpretation

 

 

Title: ______________________________________________

Name of Company: __________________________________

Experience Description:

Other Engineering Related Activities

Non-Engineering (including surveying)

Accurate

Section 6B – To Be Completed by Endorser

Applicant’s description in Section 6A above is:

Inaccurate Explain if inaccurate: ____________________________________________________________

Were you the applicant’s direct supervisor for this engagement?

Yes

No

If direct supervisor, were you a registered engineer?

Yes

No

State Registered/#: ______________________

Discipline: ____________________________________ Date of Issue: ___________________________________________

Signature: _________________________________________________

This is page 2 of a two-page form. Please send both pages stapled together.

PE COMITY

Section 6-C (to be completed by the endorser/reference)

 

The Georgia Board prefers that you mail this form back to the applicant in the applicant’s enclosed pre-addressed stamped envelope. Seal the envelope and sign the back flap to ensure against tampering. If you prefer to mail the form directly to the Board office at 237 Coliseum Drive, Macon, GA 31217-3858, please make a blank copy of this form and mail it back to the applicant following the directions above, then mail the completed form to the Board.

Name of Applicant: ____________________________________________________

1a. How well do you know the applicant:

very well

well

slightly

not at all

1b. List dates (months and years) of contact with the applicant: __________________ to _____________________

1c. Basis of contact:

As the applicant’s PE supervisor

As an associate or co-worker in Engineering work

Other (explain): __________________________________

Are you related by blood or marriage?

Yes

No

2.Do you have personal knowledge of the applicant’s engineering work?

Yes

No If yes, complete entire form.

If no, complete only items 3 & 10.

3.What is your opinion of the applicant’s personal integrity and reputation? __________________________________________

4. Would you employ applicant in a position of trust: Yes

No If no, explain: __________________________________

5.Using the interpretation below, please rate the practice and quality of performance of the applicant’s engineering work.

Type of Practice

Responsible Charge

Above

Average

Below

Unsatisfactory

Unknown

 

Yes

No

Average

 

Average

 

 

Engineering Design

 

 

 

 

 

 

 

Engineering Studies

 

 

 

 

 

 

 

Engineering Data Interpretation

 

 

 

 

 

 

Engineering Other

 

 

 

 

 

 

 

Interpretations:

 

 

 

 

 

 

 

Above Average:

Performance unquestionably of a professional level demonstrated through competence and creative ability.

 

Average:

Work not distinguished in content or level, but adequate for engineering purposes indicating an ability, under some supervision, to produce

 

workable design of systems and products.

 

 

 

 

 

 

Below Average:

Performance needs careful checking and rather close supervision to meet requirements.

 

 

 

Unsatisfactory:

Inadequate for “the purpose of safeguarding life, health and property.”

 

 

 

 

Unknown:

Did not review work or work with applicant in this area. Cannot determine proficiency.

 

 

 

6.Licensure in Georgia is not by classification of any discipline of Engineering practice. However, the Board is interested in the applicant’s background and experience and appreciates your appraisal in selecting the discipline in which the applicant is most proficient.

Civil Breadth with Depth in:

Environmental

Geotechnical

Structural

Transportation

Water Resources

Structural I

Electrical

Environmental

Mechanical

Other ______________________

7. Considering the need to protect the public health, safety and welfare, in your opinion how does this applicant rank in professional

competence and responsibility:

Qualified

Additional Experience Needed

Unqualified

8.Remarks: The Board will appreciate additional information or amplifying information regarding the applicant’s engineering experience, capabilities, or limitation, if any. Use reverse side for continuation of comments, if necessary.

_______________________________________________________________________________________________________

9.Based on the definition of the practice of engineering, GA Law 43-15-2(11), do you recommend the applicant for PE licensure?

Yes

No

10.I certify that the above statements are true and correct to the best of my personal knowledge, not made for the purpose of aiding an unqualified applicant to become licensed but with full realization of the responsibility toward the public where the safeguarding of life, health and property is concerned or involved.

Print Name: ____________________________________________________________________________________________

FirstMILast

State of PE License/Number: __________________ Date Issued: _____________ Discipline: __________________________

Present Position: ______________________________________ Firm: ____________________________________________

Address: _____________________________________________

Daytime Phone: (_____) _________________________________

Signature: ______________________________Date: __________

SEAL

If licensed, please verify with professional engineer seal with signature.

Georgia State Board of Registration for

Professional Engineers & Land Surveyors

VERIFICATION OF OUT-OF-STATE LICENSURE

EXAMINATION AND REGISTRATION

Instructions to the Applicant:

1.The Applicant should:

a.Complete his or her name and address on the top portion, upper right corner on the reverse side of this form.

b.Fill in the name of the state board completing this form.

c.Forward this form to the out-of-state board where the applicant is certified or registered.

2.Comity Applicants should:

a.Submit a form to the state of their Engineer-In-Training (EIT) and to the state of their initial Professional Engineer (PE) registration.

b.If registration is not currently valid in the state of the initial registration, submit a form to the state where a current valid registration is held.

c.If the applicant currently lives in a state other than initial licensure, submit a form to that state. If the applicant is not licensed in the state of residence, please indicate in Section 1 of the application.

3.This form may be copied if necessary.

Notes to applicant:

1.It is the policy of some states/agencies is to only send the verification/documentation directly to the Georgia Board rather than to the applicant. This is permissible.

2.It is the policy of some states/agencies to charge a fee for verification and if so, the state will not process the request until the fee is received. Before you mail this verification request to the state Board, check their website or call them to verify their fee policy.

Instructions to the Out-of-State Board:

The Out-of-State Board should complete Sections 1 - 4 on the reverse side of this form, enter the appropriate state name, and return to the applicant in a sealed envelope with an official signature on the flap of the envelope to assure no tampering. The Georgia Board will not accept this form to be transmitted via e-mail or fax.

REQUEST FOR VERIFICATION OF REGISTRATION OR EXAMINATION FOR PE COMITY APPLICANT

TO (State Requested): ________

Date:

_______________

 

 

 

 

Name:

_____________________________________________

FROM: GA Board of PELS

Address:

_____________________________________________

237 Coliseum Drive

 

_____________________________________________

Macon, GA 31217

City:

________________

State: ____

Zip:

________

 

SSN:

____-____-_______

DOB:

____/____/______

1.THE ABOVE NAMED PERSON WAS CERTIFIED OR REGISTERED AS:

 

Certificate

Date

Valid Until

 

#

Issued

 

 

Engineer-In-Training/Engineer Intern……………………..

________

________

________

________

________

________

Professional Engineer………………………………………

________

________

________

Land Surveyor-In-Training/Land Surveyor Intern…………

________

________

________

Land Surveyor………………………………………………..

________

________

________

2.BASIS OF REGISTRATION:

 

 

 

(Pass/Fail)

(Yes/No)

 

 

 

Hours

Results

NCEES

Exam Date

Written Examination:

FE

________

________

________

________

 

PE

________

________

________

________

 

FLS

________

________

________

________

 

LS

________

________

________

________

Other

Other

________

________

________

________

Examination Option:

_________________________________________________(Discipline)

Oral Examination:

Hours PE _____________

Hours LS ___________________

EIT/LSIT Accepted from: ___________________________________________________________

PE/LS Accepted from:

___________________________________________________________

Other: ____________________________________________________________________

3.QUESTIONS:

1.

Has any disciplinary action ever been taken against the applicant?

Yes

No

2.

If so, has this disciplinary case been satisfied to the Board’s requirements?

Yes

No

 

(If not, give details):

 

 

4. REMARKS:

(BOARD SEAL)

 

By:_____________________________________ Title:___________________________ Date:__________

Verifying State:____________________________

(If a fee is required, please notify the applicant but do not delay the processing of this form)

Document Specs

Fact Name Detail
Form Issuer Georgia State Board of Professional Engineers & Land Surveyors
Contact Details 237 Coliseum Drive, Macon, Georgia 31217 - (478) 207-2440
Application Type Application for Certificate as a Professional Engineer
Application Fee $70 (non-refundable)
License Type Focused Professional Engineer
Method of Application Comity or Original PE license from another state
Official Website www.sos.ga.gov/plb/pels/
Documentation Requirement for NCEES Record Holders Sections 1 through 5 must be filled out completely; no need for endorsements, verification of licensure/exams, or transcripts
Governing Law for Applicant Affidavit O.C.G.A. § 50-36-1

Instructions on Writing Georgia Pe Comity Application

Filling out the Georgia PE Comity Application form is an important step for engineers seeking to be recognized as Professional Engineers through the comity or reciprocity process in Georgia. This detailed guide simplifies the process of completing the application. By following these instructions, you will provide all the necessary information to the Georgia State Board of Professional Engineers and Land Surveyors, ensuring your application is processed efficiently.

  1. Start by entering the application fee of $70 at the top of the form, noting that this fee is non-refundable.
  2. Under the section for License Type, mark "PROFESSIONAL ENGINEER" as your selection.
  3. Fill in any Additional License Types you might have that were previously issued by the Georgia Professional Licensing Boards. Specify how each was obtained under "Method Obtained by."
  4. Enter the original PE license state under "Applicant is applying for above referenced license by Comity."
  5. Provide the Name as desired on the License and if different, include Name as shown on exam records or transcripts.
  6. Input your Social Security Number, Date of Birth, Physical Address (note: P.O. Boxes are not accepted), and Mailing Address (if different).
  7. Fill in your Telephone (Day and Evening) numbers and Email Address.
  8. Under Affiliation, state the Name of the firm, along with its Physical and Mailing Addresses (if different).
  9. Proceed to Section 1: General Information. Fill this out with up-to-date details, including your home and preferred addresses, social security number, birthplace, date of birth, business and home phone numbers. Answer all yes or no questions accurately and provide documentation where necessary.
  10. In Section 2: Registration, enter your EIT and PE information, such as state, certificate number, and date of certification or registration. List all states where you are currently registered as a PE and any pending applications.
  11. If you hold an NCEES Record, indicate this and ensure all of Sections 1 through 5 are completed. Contact NCEES to have your record sent electronically to the Georgia Board.
  12. For those without an NCEES Record, prepare to submit supporting documents as indicated, including transcripts, verification of licensure or exams, and endorsements.
  13. In Section 3: Engineering Experience, detail all relevant employment, ensuring the information corresponds with your endorsements.
  14. Fill out Section 4: Education, listing all educational institutions attended and degrees earned.
  15. Complete Section 5: Affidavit by Applicant, swearing all information is true and accurate. Choose the appropriate attestation regarding your citizenship or legal residency status and sign the form. Your signature must be notarized.
  16. Review your application thoroughly to ensure all sections are complete and accurate before submission.

After submitting your application with the required fee and supporting documents, the Georgia State Board of Professional Engineers & Land Surveyors will review your materials. The board will assess your qualifications for a Professional Engineer license by comity. You may need to be patient, as this review process can take some time. Once your application is approved, you will receive notification and further instructions on securing your official license. Remember, maintaining accuracy and completeness in your application is crucial for a successful review process.

Understanding Georgia Pe Comity Application

What is the application fee for the Georgia Professional Engineer Comity Application?

The application fee required for the Professional Engineer Comity Application in Georgia is $70. This fee is non-refundable and must be submitted with the application for it to be processed.

What information must be provided in the comity application?

Applicants are required to provide detailed personal information, including their name as it will appear on the license, social security number, date of birth, physical and mailing address, telephone numbers, and email address. They must also include information regarding their affiliation or employer, educational background, professional experience, endorsements, and details of any criminal convictions or professional disciplinary actions.

Can I apply for a Professional Engineer license in Georgia if I have a license in another state?

Yes, if you hold a Professional Engineer license in another state, you can apply for licensure in Georgia through the Comity application process. This process is designed for those who are already licensed in another jurisdiction and seek to have their credentials recognized in Georgia.

What is required for NCEES Record holders when applying?

NCEES Record holders must fill out sections 1 through 5 of the application form. They are not required to submit endorsements, verification of licensure/examinations, or transcripts, as those items are included in the NCEES Record. The NCEES Record must be electronically transmitted to the Georgia Board for consideration.

What documents are required if I do not hold an NCEES Council Record?

If you do not have an NCEES Council Record, you must bundle and send with your application your official transcripts, evaluation of foreign degrees (if applicable), verification of original licensure, and at least five endorsements from individuals familiar with your engineering experience. This documentation must be sent in sealed envelopes with the back flap signed to ensure no tampering.

How can I ensure that my application is processed smoothly?

To ensure smooth processing of your application, make sure all sections of the application form are fully completed, provide all the required documentation, and ensure your application is signed and notarized. Submitting complete and accurate information will help avoid delays.

What happens if I have a criminal record or previous disciplinary actions against my professional license?

If you have been convicted of a felony, misdemeanor, a crime involving a controlled substance or dangerous drug, or have had disciplinary actions against your professional license, you must provide detailed documentation of these occurrences. Failure to disclose this information accurately can result in disciplinary actions by the Georgia State Board of Registration for Professional Engineers and Land Surveyors or criminal prosecution.

Common mistakes

When filling out the Georgia PE Comity Application form, applicants often overlook several critical details that can significantly delay the processing time or even result in the dismissal of their application. One common mistake is not providing a complete physical address. The form explicitly states that a P.O. Box is not acceptable for this purpose. However, applicants frequently miss this instruction, leading to unnecessary complications in their application process.

Another frequent error is related to the affiliation section. Applicants sometimes enter incomplete information about their current employer or firm. This section requires not just the name of the firm but also its complete physical and mailing addresses. Failing to provide the full details can impede the verification process, which is a vital step in assessing an applicant's eligibility.

Additionally, a significant number of applicants fail to correctly disclose their criminal history or past disciplinary actions regarding their professional licenses. The application form asks specific questions about past convictions, license revocations, suspensions, or any other form of disciplinary action. Neglecting to provide accurate and complete information in this area can lead to serious consequences, including the denial of licensure.

One easily overlooked part of the application is the section that asks whether the applicant has ever had their name changed. Providing a clear explanation for a name change is crucial for verifiable background checks and to maintain the accuracy of professional records. A lack of detail in this section can raise questions about an applicant's credibility and the authenticity of their documentation.

The requirement to submit an official transcript from each college attended, regardless of graduation status, is another area where applicants often falter. It's not unusual for individuals to submit only the transcripts from institutions where they received a degree, ignoring the fact that the board requires a complete educational history. This requirement is in place to ensure that applicants meet the necessary educational qualifications for licensure.

Concerning the verification of licensure from other states or the original PE license, applicants sometimes assume this information will be automatically retrieved or transferred. However, the responsibility lies with the applicant to provide these verifications. In the absence of such documentation, the board lacks the necessary information to proceed with the application's review.

A common pitfall is also found in the EIT certification details. Some applicants, when filling the form, mistakenly believe that early achievements like the Engineer-in-Training certification are irrelevant or assume they do not need to be mentioned if a PE license has been obtained. However, this oversight can hinder the board's ability to evaluate the full scope of an applicant's qualifications.

The section requiring endorsements and references is another critical area where mistakes are made. Applicants often misunderstand the requirement, thinking fewer or non-PE references are adequate. The application specifies the need for five endorsements, three from currently active PEs. This misunderstanding can significantly weaken an application, as these endorsements serve as professional validations of the applicant's experience and competence.

Last but not least, applicants occasionally forget to have their signatures notarized in the final section of the application. This procedural step is mandatory for verifying the authenticity of the application. Overlooking this detail can result in an immediate dismissal of the application, as it fails to meet the basic submission criteria set by the board.

Documents used along the form

When applying for a certificate as a Professional Engineer (PE) in Georgia by comity, certain additional forms and documentation often accompany the primary application. These contribute to a comprehensive review process by the Georgia State Board of Professional Engineers & Land Surveyors. Understanding these supplementary documents can streamline the application process.

  1. Official College Transcripts: These are required for each college attended to verify educational qualifications. Transcripts must be sent directly from the educational institution to the Board.
  2. Evaluation of Foreign Degrees: For degrees obtained outside the United States, an evaluation from an approved evaluation provider verifies the degree's equivalency to U.S. education standards.
  3. Verification of Original Licensure: This verifies the applicant’s initial licensure as an Engineer in Training (EIT) and as a Professional Engineer (PE). It's essential where initial licensure was granted.
  4. Verification of Licensure in Residence State: If applicable, this document verifies a current PE license in the state where the applicant resides.
  5. Endorsements/References: Applicants are required to submit five endorsements from individuals who can attest to the applicant’s engineering experience and character. At least three must be from currently active PEs.
  6. NCEES Record: A comprehensive record from the National Council of Examiners for Engineering and Surveying (NCEES) may be submitted in lieu of separate documents for education, examination, and licensure verification.
  7. Proof of Legal Presence: To comply with O.C.G.A. § 50-36-1, applicants must provide proof of lawful presence in the United States through secure and verifiable documents.
  8. Notarization: The application must be signed and notarized to verify the authenticity of the applicant’s information and affirm understanding and agreement to abide by Georgia laws and regulations.
  9. Photo Identification: A current, government-issued photo ID (e.g., driver’s license, passport) may be required to confirm the applicant's identity.

Completing and gathering these forms and documents is a critical step in ensuring the smooth processing of a PE comity application in Georgia. Detailed attention to the requirements can expedite the review process, helping applicants achieve their professional licensure goals more efficiently.

Similar forms

The Georgia PE Comity Application form shares notable similarities with a Standard Employment Application in that both solicit detailed personal and professional information from the applicant. Each document requires the applicant to provide their full name, contact information, and employment history, including the names and addresses of current or previous employers. Like the Georgia PE Comity Application, a standard employment application often asks for qualifications specific to the job role, though in the context of professional engineering, this translates to inquiries about licensure, examinations, and professional affiliations.

Additionally, the Georgia PE Comity Application resembles a College Application to a significant degree. Both types of applications compel the applicant to chronicle their educational background thoroughly. This includes listing institutions attended, degrees earned, majors or fields of study, and graduation dates. Moreover, just as college applications may require transcripts to verify academic records, the Georgia PE Comity Application mandates submission of transcripts and, in some cases, an evaluation of foreign degrees, underscoring the importance of educational qualifications in professional credentialing processes.

Another document akin to the Georgia PE Comity Application is the Professional License Renewal form often used by state boards across various disciplines. Both documents require current licensure information, including license numbers, dates of issuance, and the licensing body. They also share a focus on regulatory compliance, necessitating applicants to disclose any criminal, civil, or professional disciplinary history that could impact their standing within the profession. This ensures that licensed professionals meet ongoing ethical and professional standards.

Finally, the Georgia PE Comity Application bears resemblance to a Loan Application, particularly in how both solicit detailed personal information to verify the applicant's identity and eligibility. Similar to how loan applications require information on financial status and history, the Georgia PE Comity Application requires disclosure of any past legal issues that may affect the applicant’s professional licensure status. While serving distinctly different purposes, both document types involve a comprehensive review process to assess the applicant's suitability — in one case for financial trustworthiness, and in the other, for professional competency and integrity.

Dos and Don'ts

When filling out the Georgia PE Comity Application form, certain practices should be followed for an accurate and compliant submission. Below are lists of things you should and shouldn't do during the application process.

What You Should Do:

  1. Provide accurate and complete information for all sections that are applicable to your situation, including any previous or current licenses held in other states.
  2. Consult the NCEES if you hold an NCEES Record, to have them electronically transmit your record to the Georgia Board as part of your application.
  3. Ensure all supporting documentation, such as transcripts, licensure verifications, and endorsements, are sent in sealed envelopes with the back flap signed to prevent tampering.
  4. Sign your application in the presence of a notary and have it notarized, as required in Section 5 of the application form.
  5. Include the non-refundable $70 application fee with your submission to avoid processing delays.

What You Shouldn't Do:

  1. Do not leave any sections blank that are relevant to your application. Incomplete applications may result in delays or denial.
  2. Avoid using a P.O. Box for your physical address, as the form specifies that a P.O. Box is not acceptable for this purpose.
  3. Do not submit unofficial copies of required documents such as transcripts or verification of licensure. Only official, sealed copies are acceptable.
  4. Do not forget to include your Social Security Number, Date of Birth, and other personal identification information. This is critical for processing your application.
  5. Refrain from sending incomplete or unsigned endorsements or reference forms. They must be fully completed and signed by individuals who can attest to your engineering experience and capabilities.

Misconceptions

When it comes to understanding the nuances of the Georgia PE Comity Application process, some misconceptions frequently surface. Deconstructing these can provide clarity and ease the pathway to licensure for engineers who are already licensed in another state and are seeking licensure in Georgia through comity.

  • Only the NCEES Record is necessary for the application. This is a common misunderstanding. While it's true that having an NCEES Council Record can simplify the application process since it can serve as verification of licensure, examinations, and education, it doesn't mean that it's the only requirement. Applicants without an NCEES Record must provide additional documentation, including transcripts and verification of licensure from the state where the exam was originally taken, plus any state of current licensure if different. This highlights the importance of thoroughly reviewing the specific documentation requirements for the Georgia PE Comity Application.

  • Social Security Number (SSN) is optional. The application form explicitly requires the SSN, indicating its necessity in the process. This requirement is grounded in legal stipulations for identity verification and cannot be bypassed. Ensuring that personal information is secure yet available is a critical step in completing the application accurately.

  • The application fee is refundable if the application is not approved. The application specifies that the $70 fee is non-refundable, regardless of the application's outcome. This is a standard practice in professional licensing to cover the administrative costs of reviewing applications. Understanding the non-refundable nature of this fee is essential for budgeting and financial planning during the licensure process.

  • Physical address requirements can be bypassed with a P.O. Box. The application form underlines that a P.O. Box is not an acceptable substitution for a physical address for either the applicant or their place of employment. This stipulation ensures that there is a verifiable location for official communication and legal documentation, reinforcing the importance of transparency and accountability in the professional licensure process.

Correcting these misconceptions upfront can facilitate a smoother application process, saving time and reducing the anxiety associated with regulatory paperwork. Professional engineers looking to obtain licensure in Georgia through comity should carefully read all application instructions and ensure compliance with all requirements to ensure a successful submission.

Key takeaways

When applying for the Georgia PE Comity Application, it is crucial to ensure all required information is accurate and complete. Here are the key takeaways to guide you through the process:

  • The application fee is $70, which is non-refundable, underlining the importance of correctly filling out the application to avoid unnecessary expenses due to errors.
  • Applicants must provide detailed personal information, including a desired name on the license, Social Security Number, Date of Birth, contact details, and addresses. It’s essential to note that a P.O. Box is not acceptable for the physical address, underscoring the need for a verifiable residential or business location.
  • For those holding an NCEES Record, sections 1 through 5 must be fully completed, with the NCEES Record eliminating the need to submit endorsements, verification of licensure/exams, or transcripts separately. This highlights the efficiency and ease for NCEES Record holders in the application process.
  • If an applicant does not have an NCEES Council Record, they are required to bundle official transcripts, evaluations of foreign degrees, verifications of original licensure, and endorsements with their application. Each endorsement must come from five individuals, three of whom must be currently active PEs. This comprehensive documentation ensures a thorough review process by the Georgia State Board.
  • The affidavit section mandates the applicant to swear the accuracy and truthfulness of the information provided, with a clear warning that any failure in full disclosure may result in disciplinary actions or criminal prosecution. Applicants must also attest to their legal status in the United States, emphasizing the legal compliance aspect of the licensure process.

Understanding and following these key takeaways ensure a smoother application process for the Georgia Professional Engineer (PE) Comity licensure, highlighting the critical steps towards compliance and the seriousness of the application’s accuracy.

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