Employment Agency Licensing
Mailing address: 1000 East Grand Avenue, Des Moines, IA 50319-0209
Physical address: 150 Des Moines Street, Des Moines, IA 50309 (Fed EX/UPS)
Phone: 515-725-5615 | Fax: 515-281-7995
EAL@iwd.iowa.gov | www.iowadivisionoflabor.gov
Employment Agency License Application Form PEA-1
To obtain an Employment Agency License for the current licensing year, the items listed below must be submitted
to the Iowa Division of Labor:
1. Completed Application (Form PEA-1).
2. Two signed and dated copies of the Schedule of Fees (PEA-2).
3. Surety bond in the amount of $30,000.00 executed on the Employment Agency Bond Form (PEA-3).
4. Copy of all contracts to be signed by an employee in compliance with 875 IAC – 38.6 and 38.8. State law
requires an agency use a written contract.
5. $50.00 non-refundable licensing fee by check or money order payable to “Iowa Division of Labor”.
Check one, provide information
Corporation (provide corporate name):
Partnership (provide partnership name):
Sole Proprietorship (provide owner’s name and SSN):
If Corporation or Partnership is checked above, provide names of officers or partners:
I certify that the information on this form and the attachments is true and accurate to the best of
my knowledge. I am requesting a license for the period ending June 30, .
Printed name of individual completing form Job title
Iowa Code sections 252J.8, 261.126 and 272D.8, require records of employment agency licenses issued to sole proprietors to be maintained by social security numbers (SSN). If you
are a sole proprietor and you withhold your SSN, this application will be denied. SSNs may be shared with Child Support Recovery Unit, Department of Human Services, the Student
College Aid Commission and the Department of Revenue, for use in the collection of debts. If you are behind in payments, this or future application may be denied. If you already
have a license it may be suspended or revoked. Your SSN may also be shared with other governmental agencies.