ARIZONA REGISTRAR OF CONTRACTORS
Douglas A. Ducey, Governor
1700 W. Washington Street, Suite 105 ● Phoenix AZ 85007-2812
602.542.1525 ● Within AZ 877.692.9762 ● Fax 602.542.1599 ● www.roc.az.gov
Form RC-L-200G Waiver Request Form
Rev 08/23/19
Page 1 of 1
Form
RC-L-200G
OUT-OF-STATE WAIVER REQUEST FORM
Instructions
Complete this form to request a waiver for your license application. After consideration, the Registrar may approve your request. You
must complete this form for each license you are requesting a waiver for and submit it to the state where you have held a license. This
waiver will not waive the Arizona Statutes and Rules Training Course and Exam (SRE).
Under A.R.S. §§ 32-1122(A)(4); 32-1122(E)(1); and 32-4302, the Registrar must waive certain licensing requirements if the applicant
qualifies under the conditions of these statutes.
See also
A.A.C. R4-9-106; R4-9-119. This may result in the waiver of the examination
requirements, experience requirements, or both. If you have questions regarding the applicability of waivers to your specific license
application, please contact the Registrar’s Licensing Department.
California Applicants: Arizona’s Engineering classifications may differ in scope from California’s. If applying for the Arizona A-General
Engineering license, please submit a scope letter detailing the type of work being performed in the State of Arizona prior to submitting
your application to the Registrar. Please sent the scope letter to licensing@roc.az.gov.
A. Applicant & License Information
1. Complete the information requested below;
2. Send this Waiver Request Form to the State that will verify your license and exam history;
3. Do not alter the Waiver Request Form returned from the verifying State; and
4. Enclose this Waiver Request Form with your License Application.
1. Business Name on License, including DBA if applicable 2. State Where License was Issued (e.g.
Arizona)
3. License Classification
5. Current Status of License (e.g. ‘current’, ‘suspended’, ‘revoked’, or ‘inactive’) 6. License Dates (Start – End) (MM/DD/YY)
8. Applying for Arizona License Classification
9. Applicant’s Street Address 10. City 11. State 12. Zip Code
B. Acknowledgement and Signature.
13. Signature of Person Requesting Waiver 14. Date 15. Phone Number
C. Out-of-State Verification. Only complete if requesting a waiver based on a license issued by another state.
Instructions for Verifying State:
1. Complete the information requested below;
2. Stamp this document with a State seal; and
3. Mail this verification form to the Applicant’s address (provided by the Applicant on Page 1 of the License Application).
1. Name of Board or Agency 2. Name of Person Providing Verification
3. Current License Status 4. Date this Qualifying Party was First Named on License
5. Number of Years of Experience Verified by the Board or Agency 6. Exam(s) Taken
7. Name and Date of Passing Exam 8. State Seal
D. Acknowledgement and Signature.
