The Georgia PE Comity Application form is a crucial document for engineers seeking licensure in Georgia through comity, which recognizes licenses from other states. This application requires detailed personal, educational, and professional information to ensure compliance with state regulations. If you're ready to take the next step, fill out the form by clicking the button below.
The Georgia PE Comity Application form is an essential document for engineers seeking to obtain a professional engineering license in Georgia through comity. This application is designed for individuals who already hold a Professional Engineer (PE) license in another state and wish to practice in Georgia. The form requires applicants to provide a variety of personal information, including their name, social security number, and contact details. Additionally, applicants must disclose their educational background, work experience, and any previous licenses held. Importantly, the application also addresses potential legal issues, asking if the applicant has ever faced criminal charges or disciplinary actions related to their professional conduct. The application fee is set at $70, and it's non-refundable, emphasizing the need for careful preparation before submission. For those holding an NCEES record, the process may be streamlined, as certain documentation can be submitted electronically. Overall, this form serves as a gateway for qualified engineers to expand their professional horizons in Georgia, ensuring that all applicants meet the necessary standards for licensure.
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: __________________________________________
P.O. Box not acceptable
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.
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.
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
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.
Are you currently registered as a Professional Engineer in the state where you live?
If no, why not? _________________________________________________
Has your name changed since birth?
If yes, why? ____________________________________________________
Have you ever applied to this Board for registration before?
If yes list when and what type of application _________________________________________
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_______________________________________
EIT/Date Obtained___________ _________ PE/Date Obtained____________________Discipline__________________
Section 3: Engineering Experience
Engmt
Part
From
To
Total
%
Qex
#
Company Name
Your Title
Time?
mm/yy
Months
TOTAL NUMBER OF ENDORSEMENTS FORMS: _______
Education Total
NCEES Record Requested in lieu of endorsements Yes
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
INSTITUTION AND LOCATION
FROM
TO
Date of
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)
TOTAL MONTHS
MAJOR FIELD
DEGREE EARNED
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
PLEASE LIST (references not needed)
Applicant Name: ____________________________________________
If no gap information is needed to be entered, check here:
From _______________To ______________
Description ___________________________________________________
From _______________
To ______________
Description
___________________________________________________
This is page 1 of a two-page form. Please return both pages stapled together.
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
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
#:
___/_____
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?
If direct supervisor, were you a registered engineer?
State Registered/#: ______________________
Discipline: ____________________________________ Date of Issue: ___________________________________________
Signature: _________________________________________________
This is page 2 of a two-page form. Please send both pages stapled together.
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?
2.Do you have personal knowledge of the applicant’s engineering work?
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
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
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?
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
Examination Option:
_________________________________________________(Discipline)
Oral Examination:
Hours – PE _____________
Hours – LS ___________________
EIT/LSIT Accepted from: ___________________________________________________________
PE/LS Accepted from:
___________________________________________________________
Other: ____________________________________________________________________
3.QUESTIONS:
Has any disciplinary action ever been taken against the applicant?
If so, has this disciplinary case been satisfied to the Board’s requirements?
(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)
Filling out the Georgia PE Comity Application form is an important step in your journey to becoming a licensed professional engineer in Georgia. This process requires careful attention to detail, as each section of the application must be completed accurately. After you submit your application, the board will review it along with the supporting documents you provide, so it’s essential to ensure everything is in order.
The Georgia PE Comity Application form is a document used by individuals seeking to obtain a Professional Engineer (PE) license in Georgia through the comity process. This process allows engineers who are already licensed in another state to apply for licensure in Georgia without having to retake the examination. The form collects essential information about the applicant's education, experience, and current licensure status.
To apply for licensure by comity in Georgia, an applicant must meet several requirements:
Applicants must include various supporting documents with their application. These may include:
The processing time for the Georgia PE Comity Application can vary. Generally, it may take several weeks to a few months for the Board to review the application and supporting documents. Factors that can affect processing time include the completeness of the application, the volume of applications being processed, and the need for additional information or documentation. Applicants are encouraged to ensure that all required information is submitted to avoid delays.
Completing the Georgia PE Comity Application form is a crucial step for engineers seeking licensure in the state. However, many applicants make common mistakes that can lead to delays or even denials. One significant error is failing to provide a complete and accurate physical address. The application explicitly states that a P.O. Box is not acceptable for this section. Applicants should ensure they provide a full street address, including apartment or suite numbers, to avoid complications.
Another frequent oversight involves the social security number. Some applicants mistakenly leave this field blank or provide incorrect information. This number is essential for identification and verification purposes. It is imperative to double-check that the social security number entered matches official records to prevent processing delays.
In addition, many individuals neglect to answer the questions regarding criminal history and previous licensing issues thoroughly. If an applicant has ever faced legal issues or had a license revoked or suspended, they must disclose this information and provide the necessary documentation. Omitting this information can lead to serious consequences, including the rejection of the application.
Applicants also often fail to sign and notarize the application as required. The affidavit section at the end of the form mandates a signature, and a notary public must witness this signature. Without proper notarization, the application may be deemed incomplete and returned for correction.
Moreover, many applicants do not provide sufficient endorsements. The application requires at least five endorsements from individuals who can attest to the applicant's engineering experience. Three of these endorsements must come from currently active professional engineers. Failing to secure the necessary endorsements can hinder the approval process.
Additionally, some applicants overlook the importance of submitting all required documentation. If not using an NCEES Council Record, applicants must include official transcripts, verification of licensure, and other supporting documents. Missing even one piece of documentation can result in delays or rejection of the application.
Lastly, individuals frequently misunderstand the requirement for specifying their engineering discipline. The application asks for the branch of engineering the applicant intends to practice in Georgia. Inaccurate or vague responses can lead to confusion and may affect the outcome of the application. Clarity and precision in this section are vital.
When applying for a Professional Engineer (PE) license in Georgia via the Comity Application, several additional documents are commonly required. Each of these documents plays a crucial role in verifying qualifications and ensuring compliance with state regulations.
Ensure that all required documents are complete and submitted in accordance with the application guidelines. Timely and accurate submission will facilitate a smoother review process by the Georgia State Board of Professional Engineers and Land Surveyors.
When filling out the Georgia PE Comity Application form, here are four things you should and shouldn't do:
Misconceptions about the Georgia PE Comity Application form can lead to confusion and delays. Here are six common misunderstandings:
Understanding these misconceptions can help streamline the application process and ensure that all necessary documentation is submitted correctly.
When filling out the Georgia PE Comity Application form, keep the following key takeaways in mind:
Following these guidelines will help ensure a smooth application process. Good luck!