Tdlr Form Bar PDF Details

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QuestionAnswer
Form NameTdlr Form Bar
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesblank barber license, barber license template, cosmetology license template, esthetician license template

Form Preview Example

T EX AS D EPART M EN T O F LI CEN SI N G AN D REGU LAT I O N

P. O. Box 1 2 1 5 7 - Au st in , Te x a s 7 8 7 1 1 - 2 1 5 7

(8 0 0 ) 8 0 3 - 9 2 0 2 - ( 5 1 2 ) 4

6 3 - 6 5 9 9 - FAX ( 5 1 2 ) 4 7 5 - 2 8 7 1

w w w . tdlr.texas.gov -

cs.ba r be r s@tdlr.texas.gov

APPLI CATI ON FOR:

Te x a s Ba r be r Boot h Re n t a l Pe r m it

PURSUANT TO OCCUPATI ONS CODE, CHAPTER 1601

 

 

EV EN T

FEE

PM T.

M ON EY

 

FEE

RECEI PT N UM BER

COD E

AM OUN T

AM OUN T

TYPE

 

License

 

 

$ 50 . 00

 

 

 

Fee

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D O N OT W RI TE ABOV E TH I S LI N E

N OTE: ALL I NFORMATI ON MUST BE TYPED OR PRI NTED I N I NK.

1 . Applica n t ’s Fu ll N a m e :

Last ( Fam ily Nam e)

Fir st ( Giv en Nam e)

Middle

2 . Applica n t ’s Socia l Se cu r it y N o . :

_____ _____ _____ - _____ _____ - _____ _____ _____ _____

Not e: I f y ou hav e a Social Secur it y Num ber ( SSN) , Sect ion 231 .302 of t he Tex as Fam ily Code REQUI RES all applicant s t o disclose t heir SSN w hen filing an applicat ion . The SSN t hat is pr ov ided is confident ial and is r equir ed t o enfor ce Child Suppor t or der s.

3 . D a t e of Bir t h :

Mont h

Day

Year

4 . Ge n de r :

MALE

FEMALE

( cir cle one)

5 . Applica n t ’s M a ilin g Addr e ss a n d Con t a ct I n for m a t ion : ( USED FOR ALL CORRESPONDENCE)

Num ber , St r eet and Apar t m ent No. - OR - P. O. Box Num ber

 

 

 

 

 

 

 

 

 

 

(

 

 

)

 

 

 

 

Cit y

St at e

Zip Code

Count r y

 

 

 

 

 

 

 

 

 

Ar ea Code

Phone Num ber

 

FAX Num ber : (

 

 

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ar ea Code

Phone Num ber

 

 

E- m ail Addr ess ( j ohndoe@aol. com for ex am ple)

6 . Lice n se N u m be r a n d Ex pir a t ion D a t e :

# :

 

 

 

 

 

 

 

Ex p. :

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7 .

Lice n se Type :

 

Class A Barber

I nst r uct or

Manicur ist

 

Technician

Hair Weaver

 

( Cir cle One)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hair Br aider

Technician/ Manicur ist

 

Technician/ Hair Weav er

NOTE: To receive a Booth Rental Permit, you must submit a $50 cashiers check or money order.

STATEM EN T OF APPLI CAN T

I ce r t ify t h a t I w ill com ply w it h a ll a pplica ble pr ov ision s of t h e Te x a s Occu pa t ion s Code , Ch a pt e r s 5 1 , 1 6 0 1 a n d 1 6 0 3 ; Te x . Adm in . Code , Ch a pt e r 6 0 ; a n d, t h e Ba r be r Adm in ist r a t iv e Ru le s, Te x . Adm in . Cod e , Ch a pt e r 8 2 . I u n d e r st a n d t h a t p r ov id in g fa lse in for m a t ion on t h is a pp lica t ion m a y r e su lt in r e voca t ion of t h e lice n se I a m r e qu e st in g a n d t h e im posit ion of a dm in ist r a t iv e p e n a lt ie s.

Dat e Signed

Applicant ’s Signat ur e

 

 

 

T H I S FO RM CON SI STS OF 1 PAGE.

 

 

TD LR For m BAR ( 8/ 2 0 1 3)

This docum ent is av ailable on t he TDLR w ebsit e at w w w . tdlr.texas.gov/ bar ber s/ bar ber for m s/ ht m

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blank cosmetology license template completion process clarified (stage 1)

2. Your next step is to submit the following fields: Cit y, St at e, Zip Code, Count ry, Area Code, Phone Num ber, FAX Num ber, Area Code, Phone Num ber, E m ail Address j ohndoeaolcom, Lice n se N u m be r a n d Ex, Exp, Lice n se Type Circle One, Class A Barber, and I nst ruct or.

How one can fill out blank cosmetology license template part 2

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