Navigating through the complexities of acquiring a Certificate of Registration to Purchase Refrigerant Products in Texas involves understanding the crucial details embedded in the Tdlr O23Acr form. Issued by the Texas Department of Licensing and Regulation, this form serves as the gateway for professionals in the air conditioning and refrigeration sectors to legally obtain the refrigerants necessary for their trade. With a focus on ensuring compliance with Chapter 1302, Title 8 of the Occupations Code, the form demands detailed information from applicants, including personal identification, employment details, and a declaration of any criminal history. Furthermore, it stipulates the requirement for applicants to disclose their Social Security Number and Federal EPA number - an essential step mandated for enforcing child support orders and verifying professional credentials. Highlighting a $25 registration fee, the form also outlines procedures for individuals who may have had their license affected by criminal offenses or disciplinary actions in any state, emphasizing the provision of additional documentation. The importance of accurate and truthful information is underlined by the applicant's statement, stressing the role of this form not only as an application but as a binding document subject to verification by the TDLR. Additionally, the form extends an invitation to applicants to join the Air Conditioning Contractors email notification list, offering an avenue for ongoing communication with the Department. It also highlights potential barriers to license renewal for those with defaulted student loans, promoting early resolution with the Texas Guaranteed Student Loan Corporation. As the initial step in securing the legal right to acquire refrigerants, the Tdlr O23Acr form embodies a critical process in ensuring professionals meet Texas's regulatory standards.
| Question | Answer |
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| Form Name | Tdlr Form O23Acr |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | acr023 certificate of registration to purchase refrigerant products form |
TEXAS DEPARTMENT OF LICENSING AND REGULATION
P.O. Box 12157 - Austin, Texas
www.license.state.tx.us - customer.service@license.state.tx.us
APPLICATION FOR:
CERTIFICATE OF REGISTRATION TO PURCHASE REFRIGERANT PRODUCTS
PURSUANT TO OCCUPATIONS CODE, CHAPTER 1302, TITLE 8
DO NOT WRITE IN THE FEE AREA IMMEDIATELY BELOW
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FEE |
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MONEY |
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FEE |
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RECEIPT NUMBER |
AMOUNT |
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AMOUNT |
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TYPE |
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Registration Fee |
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$25.00 |
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DO NOT WRITE ABOVE THIS LINE |
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DO NONOTE: ALL INFORMATION MUST BE TYPED OR PRINTED IN INK. |
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IF ALL REQUIREMENTS FOR A REGISTRATION ARE NOT MET WITHIN TWELVE (12) MONTHS OF THE FILING DATE, THE APPLICATION WILL BE CLOSED. |
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1. |
Applicant’s Full Name: |
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_______________________________________ |
_________________________ ___________ |
___________ |
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Last |
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First |
Middle Initial |
Suffix (JR, SR, III) |
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2. |
Date of Birth: ____________ - _________ - ____________ |
3. Gender |
Female |
Male |
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4. |
Applicant’s Social Security No.: |
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____ ____ ____ - ____ ____ - ____ ____ ____ ____ |
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Note: Section 231.302 of the Texas Family Code REQUIRES all applicants to disclose their Social Security Number (SSN) when filing an application. The SSN that is provided is confidential and is required to enforce Child Support orders. Failure to provide the SSN will prevent a license from being issued and could ultimately lead to termination of the application.
5. Federal EPA #: |
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_________________________________________ |
(This number is required.) |
6. Place of Employment: _________________________________ |
Supervisor: __________________________ |
Employment Address: STREET ADDRESS MUST BE DESIGNATED BELOW. (A license will not be issued to a P.O. Box only.)
_____________________________________________________________________________________________________
Number, Street, Suite No., Apt. No.
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(________) ____________________________________ |
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City |
State |
Zip Code |
Area Code |
Phone Number |
7.Mailing Address : (USED FOR ALL CORRESPONDENCE) (P.O. Box is allowed for this address.)
_____________________________________________________________________________________________________
Number, Street, Suite No., Apt. No. or |
P.O. Box |
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_______________________________________________________ |
(________) ___________________________________________ |
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City |
State |
Zip Code |
Area Code Phone Number |
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FAX Number: (________) |
________________________________ |
______________________________________________________ |
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Area Code |
Phone Number |
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This THIS FORM CONSISTS OF 2 PAGE S (front and back).
TDLR Form O23ACR (Revised 07/2005) This document is available on the TDLR website at www.license.state.tx.us.
8. Have you ever been convicted of a criminal offense? |
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(Include all felonies and misdemeanors other than a minor traffic violation.) |
Yes |
No |
If YES, attach a “Criminal History Questionnaire” to this application. |
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All forms may be found at www.license.state.tx.us/ac/acrforms.htm.
9. Have you ever had a license, certification or registration suspended, revoked or denied in any state?
Yes |
No If YES, submit a “Disciplinary Action Questionnaire” with this application. |
All forms may be found at www.license.state.tx.us/ac/acrforms.htm.
10.I am a maintenance person or maintenance engineer AND a bona fide employee of the property owner, property lessee, or management company where the maintenance is being performed AND do not contract with the general
public. |
Yes |
No |
11.I am a licensed professional engineer under the Texas Engineering Practice Act, AND perform work in connection with the business in which I am employed AND do not contract with the general public for air conditioning work.
Yes No
NOTICE REGARDING APPLICABLE FEES
12.If you submit an insufficient fee amount with this application, or submit an outdated application form, it may be re- turned to you. To verify the correct form version and required fees, consult the TDLR web site: (www.license.state.tx.us) or contact TDLR using the information at the top of the first page.
All fees are required with this application. TOTAL registration fee: $25.00.
STATEMENT OF APPLICANT
13.By signing this application I certify all information submitted on this and attached forms is true and accurate.
I authorize TDLR to conduct any investigations of me which it deems prudent. I understand that the information revealed in an investigation may be cause for disapproval of the application even though other requirements for a registration have been met.
________________________ |
________________________________________________ |
Date Signed |
Signature of Applicant |
NOTE 1: The Department will add your address to the Air Conditioning Contractors email notification list, which automatically provides information from the Department on matters affecting Air Conditioning and Refrigeration. Your email address is confidential pursuant to the Texas Public Informa- tion Act and the Department will not share it with the public.
See additional information at the following link: http://www.license.state.tx.us/newsletters/TDLRnotificationLists.asp.
NOTE 2: State law prohibits renewing a license more than once after a licensee has defaulted on a student loan guaranteed by the Texas Guaran- teed Student Loan Corporation (TGSLC) unless the licensee has entered into a repayment agreement with TGSLC. YOU SHOULD CONTACT TGSLC BEFORE FILING THIS APPLICATION if you have defaulted on a student loan. An application or renewal may be rejected if this agency has received information from TGSLC that the applicant has defaulted on a student loan. The Texas Guaranteed Student Loan Corporation can be con- tacted at: Texas Guaranteed Student Loan Corporation, P.O. Box 15996, Austin, Texas