TEXAS ELEVATOR CONTRACTOR REGISTRATION APPLICATION INSTRUCTIONS
AN APPLICATION IS NOT CONSIDERED COMPLETE AND UNTIL ALL ITEMS HAVE BEEN SUBMITTED AS
REQUIRED.
GENERAL INSTRUCTIONS
The application must be completed and signed by the applicant. All information provided must be typed or clearly printed
in black ink.
1. BUSINESS NAME – Full name the business is operating under. (40 characters maximum)
2. TELEPHONE NUMBER – Provide the area code and telephone number of the business.
3. FAX NUMBER – Provide the area code and fax number of the business.
4. FEDERAL ID NUMBER – Provide the federal ID number that is used by the business.
5. MAILING ADDRESS – This is the address to which the Department will mail your correspondence. Indicate the
number and street, or post office box of your mailing address.
6. BUSINESS PHYSICAL ADDRESS – This address is the actual location of the business. If this address is the same as
your mailing address, you may indicate SAME. A post office box will not be accepted as a physical address.
7. CONTACT NAME & TITLE – Please provide your name and title in the spaces provided.
8. MAILING ADDRESS – Provide the mailing address to be used for all correspondence.
9. TELEPHONE NUMBER – Provide the area code and telephone number of the contact person. If this number is the
same as the business number, you may write/type SAME.
10. BUSINESS EMAIL ADDRESS – Provide your business email address. By providing my email address I authorize
TDLR to send licensing communications and required notices to me by electronic mail. I understand that I may revoke
this authorization in writing and that I must update my email address, or I will not receive these notices. I understand
that the email address I provide on this application will be available to the public.
11. BUSINESS STRUCTURE – Indicate in the box provided how the business is organized. Select only one.
12. INSURANCE – You must attach proof of the minimum liability insurance required by law and rule.
LIABILITY INSURANCE
Elevator contractors are required to maintain at least the minimum general liability insurance cover- age at all times to
satisfy proof of financial responsibility. The insurance must be:
(1) at least $1,000,000 per occurrence of bodily injury or death, and
(2) at least $500,000 per occurrence of property damage
Proof of the required general liability insurance may be submitted on an industry standard certificate of insurance
ACORD form or on a certificate of insurance form approved by the Texas Department of Insurance. The certificate of
insurance must contain a 30-day cancellation notice to TDLR as required under Rule 74.40. Insurance must be
obtained from an insurance provider authorized to sell general liability insurance in Texas pursuant to the Texas
Insurance Code.
Responsible Party Designee To designate a responsible party for the contractor application you will need to
complete the Responsible Party Designee application.
13. FEES – The fee for this application is $115. All fees are non-refundable. Please send check or money order for the
total amount due, payable to TDLR.
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TDLR Form ELE003 rev August 2021
