Registration Application Procedure
The steps below will guide you in completing the registration application in the correct order.
Indicate Registration Status
If you are a new applicant registering for the first time or renewing your annual registration, please check the proper box. Please indicate the year(s) for which you are seeking registration.
Please enter the city and county where the business is located.
Please list the business address where the device(s) is located. Please complete a separate application for each business location. The application can be duplicated.
Mailing Address(Complete if Different from Above.)
Please enter your mailing address only if it is different from the address(es) listed above. If you do not want your certificate(s) forwarded to an address where the device(s) is located, please provide a supplementary mailing address.
List the Device Information in the Chart Below
Please enter the type of device(s) located at your business. Refer to the back of the application to obtain the proper fee schedule and device information.
| Scale|| 01 || X234|| 345678 || TipTop Inc.|| 100 lbs ||0||$25|
|Disp/Hoses|| 10|| H320 || SR2345 || Redact Inc.||0|| 3 || $75|