Free Sfn 12012 PDF Template
The SFN 12012 form serves as the Contractor License Application in the state of North Dakota, a critical document for contractors planning to engage in projects exceeding a value of $2,000. This form outlines the necessary steps for obtaining a contractor's license, which is essential for compliance with state regulations. Applicants must select the appropriate class of license based on the project value, with fees varying accordingly—Class A allows for unlimited contract value, while Classes B, C, and D have specific limits. Each business type, whether a sole proprietorship, partnership, corporation, or limited liability company, has distinct requirements for listing owners and partners. Additionally, the form mandates proof of workers' compensation insurance and liability coverage, ensuring that contractors are adequately protected. Applicants must also disclose any previous licensing issues or legal challenges, as this information is vital for maintaining the integrity of the licensing process. The form emphasizes the importance of providing accurate and complete information, as incomplete applications may result in delays or retention of fees. Understanding these aspects is crucial for any contractor seeking to operate legally and successfully in North Dakota.
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Similar forms
The SFN 12012 form, used for contractor licensing in North Dakota, shares similarities with several other important documents. Here are four documents that are comparable:
- Contractor License Application (State Level): Similar to the SFN 12012, this application also requires detailed information about the business and its owners. Both forms ensure that contractors meet state regulations before they can operate legally.
- Articles of Incorporation Form: When establishing a corporation, ensure you have the comprehensive Articles of Incorporation documentation to meet state registration requirements.
- Certificate of Insurance: Like the requirement for proof of liability insurance in the SFN 12012, this document serves as evidence that a contractor has the necessary insurance coverage to protect against potential claims. Both documents aim to safeguard the public and the contractor.
- Sales and Use Tax Permit Application: This application, similar to the SFN 12012, requires businesses to provide information about their operations. Both documents help ensure that contractors comply with state tax regulations and maintain accurate records.
- Business Registration Form: Just as the SFN 12012 requires information about the business structure and ownership, a business registration form collects essential details to establish a business legally. Both forms are crucial for maintaining transparency and accountability in business operations.
How to Use Sfn 12012
Filling out the SFN 12012 form is an essential step for contractors seeking a license in North Dakota. The form collects important information about your business and qualifications. Be sure to have all necessary documents and details on hand to ensure a smooth application process.
- Determine the appropriate class of license required based on the value of your contracts. Select Class A, B, C, or D, and note the associated fee.
- Provide your business name as registered in North Dakota, along with your business telephone number, complete mailing address, city, state, zip code, email address, and web address.
- If applicable, list all partners for a general partnership or managing partners for a limited liability partnership, including their full names, addresses, and Social Security or Federal ID numbers. Attach an additional sheet if necessary.
- Indicate whether you have a North Dakota Sales and Use Tax permit. If yes, include the permit number.
- Submit a statement from North Dakota Workforce Safety & Insurance confirming you have workers' compensation coverage or a verification of nonemployment if you have no employees.
- Complete the business type section, providing the business Federal ID and the name and Social Security/Federal ID number of the owner or managing partner.
- File a Certificate of Insurance indicating liability coverage, naming the ND Secretary of State as the certificate holder.
- Answer whether you hold a contractor license in another state and provide the details if applicable.
- Describe your experience and qualifications as a contractor, including years in business and any relevant training or licenses.
- If applicable, answer the questions regarding any past license denials, lawsuits, bankruptcies, judgments, or criminal charges, and attach a separate sheet with details.
- Complete the affidavit section, signing before a notary public.
- Submit the completed form along with the appropriate fee to the Secretary of State's office.
After submitting the form, the licensing process will begin. Ensure that all requirements are fulfilled within 90 days to avoid any retention of your filing fee. Stay in touch with the Secretary of State's office for updates on your application status.
Dos and Don'ts
When filling out the SFN 12012 form for a contractor license application in North Dakota, it is essential to follow certain guidelines to ensure your application is processed smoothly. Here’s a list of things you should and shouldn’t do:
- Do read the instructions carefully before starting the application.
- Don’t leave any required fields blank; incomplete applications may be rejected.
- Do provide accurate and up-to-date information about your business.
- Don’t forget to include your business name exactly as registered in North Dakota.
- Do check the appropriate class of license and corresponding fee based on your contract value.
- Don’t use a fictitious name unless it is registered with the Business Division.
- Do ensure that all partners or managing members are listed with their required details.
- Don’t neglect to attach any additional sheets if more space is needed for partners’ information.
- Do obtain and attach proof of workers' compensation coverage.
- Don’t forget to sign the affidavit before a notary public, as this is a crucial step in the process.
Following these guidelines will help you avoid common pitfalls and ensure that your application is complete and accurate. Good luck with your application!
Document Example
CONTRACTOR LICENSE APPLICATION
SECRETARY OF STATE
SFN 12012 (10 - 2011)
Instructions:
1.Contractors working on any project where the cost, value, or price per job or contract exceeds $2,000.00 must hold a North Dakota Contractors License.
2.As stated in North Dakota Century Code, Chapter
Check Appropriate Class of License
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CLASS |
REQUIRED FOR |
FEE |
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Class A License |
no limitation on the value of any |
$ |
300.00 |
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single contract |
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Class B License |
any contract up to |
$ |
250,000 |
$ |
200.00 |
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Class C License |
any contract up to |
$ |
120,000 |
$ |
150.00 |
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Class D License |
any contract up to |
$ |
50,000 |
$ |
50.00 |
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3. The business name as registered in North Dakota:
For Office Use Only
ID Number
WO Number
License Number
Issued By
Secretary of State
State of North Dakota
600 E Boulevard Ave Dept 108
Bismarck ND
Telephone |
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Toll Free |
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Ext |
Fax |
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Web Page: |
www.nd.gov/sos |
Email: |
sosadlic@nd.gov |
Business Name of Applicant |
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Business Telephone Number |
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Complete Mailing Address |
City |
State |
Zip Code |
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Web Address |
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4.If the business is a GENERAL PARTNERSHIP, all partners must be listed including full name, address, city, state, zip code, and Social Security or Federal ID number of each partner. If adequate space is not provided to list all general partners, attach an additional sheet listing all others.
If the partnership uses a fictitious name, the fictitious name must be registered with the Business Division
If the business is a LIMITED LIABILITY PARTNERSHIP, all managing partners must be listed including full name, address, city, state, zip code, and Social Security or Federal ID number of each managing partner. If adequate space is not provided to list all managing partners, attach an additional sheet listing all others. The limited liability partnership must be registered with the Business Division
If the business is a CORPORATION or LIMITED LIABILITY COMPANY it must be registered with the Business Division
If the business is a SOLE PROPRIETORSHIP which uses a trade name, the trade name must be registered with the Business Division
5. Does the applicant have a North Dakota Sales and Use Tax permit? |
Yes No If yes, provide the number _____________________. |
For information regarding this permit, contact the North Dakota Tax Department at
6.North Dakota Century Code, Section
7.In compliance with the Federal Privacy Act of 1974, the disclosure of the social security number or Federal ID number on this form is voluntary. They are not disclosed to the public. The numbers are used by the Secretary of State to maintain accurate contractor files. Therefore, while voluntary disclosure is requested, failure to do so will not invalidate this application.
For the purpose of qualifying for a contractor's license, the applicant submits, under oath, the following information:
A. Business Type |
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B. Business Federal ID |
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Sole Proprietorship - Complete C Below |
Limited Liability Company - state of origin _________ |
Number |
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General Partnership - Complete C & D Below |
Corporation - state of origin _________ |
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Limited Liability Partnership - state of origin __________ |
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Complete C & D Below |
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C. Name of Owner (or General Partner or Managing Partner) |
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Social Security/Federal ID Number |
Home Telephone Number |
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Complete Mailing Address |
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State |
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Zip Code |
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D. Name of General Partner (or Managing Partner) |
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Social Security/Federal ID Number |
Home Telephone Number |
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Complete Mailing Address |
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8.North Dakota Century Code, Section
9.In addition to a contractor's license, you may need to obtain other licenses or permits as required by law (e.g. the State Electrical Board, the State Plumbing Board, Transient Merchant License from the Attorney General or Asbestos Abatement from the Health Department).
(continue on reverse side)
SFN 12012 (10 - 2011) Page 2
10. Do you hold a contractor license in another state?
No
Yes If Yes, indicate the state(s)______________________________________________________________________________________
11.The applicant's experience and/or qualifications to act in the capacity of a contractor. This may include, but is not limited to, the number of years in the business, licenses in other states, detailed explaination of what type of work is being done, training, school, and any other pertinent information.
12. If your answer is "YES" to any of the following questions, give the details on a separate sheet and attach to this application.
a. Has any license been denied, suspended or revoked For you?
For any officer?
For any partner?
For any entity with which you, officers or partners have or are associated with?
Yes
Yes
Yes
Yes
No No
No No
b.Have there been any civil lawsuits or arbitration proceedings in which you (or a corporation, limited liability company, or partnership of which you are or were an officer or partner) were involved as a defendant in which fraud or misrepresentation was charged during the
past year? |
As a Defendant |
Yes |
No |
Yes
No
c.Have you or a corporation, limited liability company, or partnership of which you are or were an officer or partner, been involved in bankruptcy proceedings during the past five years?
Yes
No
d.Are there any judgments, arbitration awards, mechanics liens or federal or state tax liens against you, or a corporation, limited liability company, or partnership of which you are an officer or partner, in North Dakota or elsewhere?
Yes |
No |
e. Has the applicant, or officers or partners of the applicant been charged with or convicted of a felony or misdemeanor within the last five years?
Yes
No If Yes, indicate the date, name of the individual charged or convicted, city, state, disposition, and whether a felony or misdemeanor. (This includes ALL crimes, including nonsufficient funds checks, no account checks, and DUIs.)
13.Once the licensing process has started and the requirements are not completed or perfected within 90 days, one half of the filing fee submitted will be retained and the other half returned to the applicant.
14.North Dakota Century Code, Section
AFFIDAVIT
(Sign before a notary)
The Applicant, who is 18 years of age or older, whose name is ________________________________________________________________, being first
duly sworn on oath deposes and says he/she is the applicant above named, or the ______________________________________ of the corporation or a
member of the firm, association, or
this affidavit for and on behalf of said applicant; that he/she has read the within and foregoing application and knows the contents thereof, and that the
statements therein contained are true of his/her own personal knowledge, except as to such statement therein made upon information and belief, and as to
such statements he/she believes the same to be true.
State of ______________________ |
Signature of Applicant |
County of ____________________ |
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The foregoing instrument was acknowledged before me this ________ day of _______________________, 20 _______.
(Notary Seal/Stamp) |
Notary Public |
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My Commission Expires______________________________ |
File Breakdown
| Fact Name | Fact Description |
|---|---|
| Form Purpose | The SFN 12012 form is used for applying for a contractor license in North Dakota. |
| Application Requirement | Contractors must hold a license for projects exceeding $2,000.00 in value. |
| License Classes | There are four classes of licenses based on contract value: Class A, B, C, and D. |
| Governing Law | This form is governed by North Dakota Century Code, Chapter 43-07-07. |
| Workers Compensation | Applicants must provide proof of workers compensation coverage as per ND Century Code, Section 43-07-04. |
| Liability Insurance | A certificate of insurance indicating liability coverage is also required. |
| Non-resident Applicants | Non-residents appoint the Secretary of State as their lawful agent for legal processes. |
Common mistakes
Filling out the SFN 12012 form can be a straightforward process, but many applicants make common mistakes that can lead to delays or complications. One frequent error is failing to select the correct class of license. Each class corresponds to specific contract values, and selecting the wrong one can result in an application being rejected. For instance, if a contractor plans to work on a project exceeding $250,000 but mistakenly applies for a Class B license, the application will not meet the requirements, causing unnecessary setbacks.
Another mistake involves incomplete or inaccurate information regarding the business name and address. It's crucial to ensure that the business name matches exactly with what is registered in North Dakota. If there are discrepancies, such as typos or variations in spelling, it could lead to confusion and further delays. Additionally, omitting essential details like the business telephone number or email address can hinder communication with the Secretary of State's office, making it difficult to resolve any issues that may arise during the application process.
Many applicants also overlook the requirement to provide a statement of workers' compensation coverage. This is a critical part of the application. If the applicant does not have employees, they must submit a verification of non-employment. Failing to include this documentation can result in the application being deemed incomplete. It’s advisable to double-check that all necessary paperwork is attached before submission to avoid this common pitfall.
Lastly, neglecting to disclose previous legal issues can be detrimental. Applicants must answer questions regarding any past license denials, civil lawsuits, or criminal charges. Providing inaccurate information, even unintentionally, can lead to serious consequences, including denial of the application. Being transparent and thorough in this section is essential to ensure a smooth licensing process. Taking the time to carefully review and complete each section of the SFN 12012 form can save applicants from unnecessary headaches and delays.
FAQ
What is the purpose of the SFN 12012 form?
The SFN 12012 form is used to apply for a contractor's license in North Dakota. It is required for contractors working on projects where the cost, value, or price exceeds $2,000. The form collects essential information about the applicant, including business details, license class, and proof of insurance and workers' compensation coverage. Completing this form is a necessary step to legally operate as a contractor in the state.
What are the different classes of contractor licenses available?
North Dakota offers several classes of contractor licenses based on the value of contracts. The classes are as follows: Class A has no limitations on contract value and requires a fee of $300. Class B covers contracts up to $250,000 with a fee of $200. Class C is for contracts up to $120,000 and costs $150. Lastly, Class D is for contracts up to $50,000 and has a fee of $50. Applicants must select the appropriate class based on their expected contract values.
What documentation is required to complete the application?
To complete the SFN 12012 application, several documents are needed. Applicants must provide a statement from North Dakota Workforce Safety & Insurance confirming workers' compensation coverage or a verification of nonemployment if there are no employees. Additionally, a certificate of insurance indicating liability coverage must be submitted. This certificate should name the North Dakota Secretary of State as the certificate holder. If the business uses a fictitious name, that name must also be registered with the Business Division.
What happens if the application requirements are not completed within a certain time frame?
If the licensing process is not completed within 90 days, half of the filing fee will be retained by the Secretary of State, while the remaining half will be returned to the applicant. This policy encourages timely submission of the required documentation and completion of the application process.