Form DLI-ERD-WCR001 "Application for Home Inspector Registration" - Montana

What Is Form DLI-ERD-WCR001?

This is a legal form that was released by the Montana Department of Labor and Industry - a government authority operating within Montana. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2020;
  • The latest edition provided by the Montana Department of Labor and Industry;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DLI-ERD-WCR001 by clicking the link below or browse more documents and templates provided by the Montana Department of Labor and Industry.

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Download Form DLI-ERD-WCR001 "Application for Home Inspector Registration" - Montana

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APPLICATION for
Home Inspector Registration
VALID FOR TWO (2) YEARS | $80 FEE (NON-REFUNDABLE)
INSTRUCTIONS:
THIS BLOCK FOR OFFICE USE
Complete this registration if you are a Home Inspector working in Montana.
Provide supporting documents as required.
Enclose a check or money order payable to the Montana Department of Labor & Industry in the amount
of $80 (non-refundable) or pay online.
Send this completed application to: Registration Section • PO Box 8011 • Helena, MT 59604-8011
Visit our website: mtcontractor.mt.gov or call (406) 444-7734 for assistance
**Incomplete and/or inaccurate applications may be denied**
APPLICANT INFORMATION
Business Name:
Is this your first time applying?
(If not using a business name, write your personal name)
☐ Yes ☐ No
Mailing Address:
City:
State:
Zip:
Federal Employer Identification Number (FEIN)/SSN:
Home Inspector Registration Number (if known):
Phone:
Email:
Business Structure:
(Selection must match your business name registration with Montana Secretary of State; contact their office at (406) 444-3665 or visit
sosmt.gov for verification)
☐ Sole Proprietor
☐ Partnership or LLP
☐ Member-Managed LLC
☐ Manager-Managed LLC
☐ Corporation
Does your business have Employees? ☐ Yes ☐ No
Name of workers' compensation insurance company:
Policy #:
Does your business use Leased Employees? ☐ Yes ☐ No
Name of Professional Employer Organization (PEO):
Policy #:
General Liability and Error and Omissions Policy Requirements
Home Inspectors are required to be covered by a minimum of $100,000 general commercial liability insurance and a minimum of
$100,000 errors and omissions (E&O) insurance. Please provide evidence of both. **Failure to keep insurance active at all times
may result in suspension of your Registration.**
☐ This business is covered by an active policy that meets the above requirements and provides coverage for the business’s home
inspection workers. A certificate of insurance is enclosed as proof.
▪ Home Inspector Registration does not supersede requirements of other government agencies or entities▪
EACH INDIVIDUAL PERFORMING HOME INSPECTIONS
UNDER THIS BUSINESS NAME
MUST COMPLETE AND SUBMIT PAGE 2
Revised: Mar 2020
DLI-ERD-WCR001
Page 1 of 2
APPLICATION for
Home Inspector Registration
VALID FOR TWO (2) YEARS | $80 FEE (NON-REFUNDABLE)
INSTRUCTIONS:
THIS BLOCK FOR OFFICE USE
Complete this registration if you are a Home Inspector working in Montana.
Provide supporting documents as required.
Enclose a check or money order payable to the Montana Department of Labor & Industry in the amount
of $80 (non-refundable) or pay online.
Send this completed application to: Registration Section • PO Box 8011 • Helena, MT 59604-8011
Visit our website: mtcontractor.mt.gov or call (406) 444-7734 for assistance
**Incomplete and/or inaccurate applications may be denied**
APPLICANT INFORMATION
Business Name:
Is this your first time applying?
(If not using a business name, write your personal name)
☐ Yes ☐ No
Mailing Address:
City:
State:
Zip:
Federal Employer Identification Number (FEIN)/SSN:
Home Inspector Registration Number (if known):
Phone:
Email:
Business Structure:
(Selection must match your business name registration with Montana Secretary of State; contact their office at (406) 444-3665 or visit
sosmt.gov for verification)
☐ Sole Proprietor
☐ Partnership or LLP
☐ Member-Managed LLC
☐ Manager-Managed LLC
☐ Corporation
Does your business have Employees? ☐ Yes ☐ No
Name of workers' compensation insurance company:
Policy #:
Does your business use Leased Employees? ☐ Yes ☐ No
Name of Professional Employer Organization (PEO):
Policy #:
General Liability and Error and Omissions Policy Requirements
Home Inspectors are required to be covered by a minimum of $100,000 general commercial liability insurance and a minimum of
$100,000 errors and omissions (E&O) insurance. Please provide evidence of both. **Failure to keep insurance active at all times
may result in suspension of your Registration.**
☐ This business is covered by an active policy that meets the above requirements and provides coverage for the business’s home
inspection workers. A certificate of insurance is enclosed as proof.
▪ Home Inspector Registration does not supersede requirements of other government agencies or entities▪
EACH INDIVIDUAL PERFORMING HOME INSPECTIONS
UNDER THIS BUSINESS NAME
MUST COMPLETE AND SUBMIT PAGE 2
Revised: Mar 2020
DLI-ERD-WCR001
Page 1 of 2
Each individual performing home inspections under the business name must complete this form in its entirety
1. INSPECTOR INFORMATION
First Name:
MI:
Last Name:
SSN:
Mailing Address:
City:
State:
Zip:
Phone:
Email:
Select the
most appropriate
☐ I
am
an owner/partner/member
Percent
Owned:
_________%
(skip ahead to section 2)
answer:
☐ I
am
a corporate officer/manager Percent
Owned:
_________%
☐ I am an employee (skip ahead to section 3)
CORPORATION and MANAGER-MANAGED
LLC businesses, select the most appropriate answer:
Corporate officers working in Montana are
considered employees and must be covered under a Montana workers’ compensation
insurance policy, unless the officer owns 20% or more of the shares of the corporation, or is related to another officer of the
corporation and the aggregated shares equal 20% or more.
☐ I own 20% or more of the number of shares of stock in the corporation or own 20% or more of the LLC; or
☐ I own less than 20% of the number of shares of stock in the corporation or LLC, but when my ownership is aggregated with the
shares owned by a person or persons listed in the third category, the total is 20% or more of the number of shares in the
corporation or LLC; or
☐ I am the spouse, child, adopted child, stepchild, mother, father, son-in-law, daughter-in-law, nephew, niece, brother, or sister of
a corporate officer who meets one of the requirements above.
2. WORKERS’ COMPENSATION REQUIREMENTS
Persons actively working in Montana as a Sole Proprietor, or members of a Partnership or LLP,
OR Member-Managed LLC who
are
NOT personally covered under a Montana workers’ compensation insurance policy must apply
for an independent contractor
exemption certificate (ICEC).
Do you have an active independent contractor exemption
certificate (ICEC) for the
☐ Yes
IC# _____________
occupation of Home Inspector or Home Inspection?
☐ No
Are you
covered under MT workers’ compensation?
☐ Yes
Name of workers’ compensation insurance company: ________________________________________________________
Policy #: ________________________________________________________
☐ No
If no, you may be required to have an ICEC
3. PROFESSIONAL MEMBERSHIP REQUIREMENTS
Home Inspectors are required to be a member of a national home inspection association. Please provide evidence of membership.
**Failure to keep membership active at all times may result in suspension of your Registration.**
☐ I am currently a member of a national home inspector association
Provide Name of Association:
Membership #
Expiration:
4. EDUCATION REQUIREMENTS
For a first time registration, Home Inspectors are required to provide documentation that they have successfully completed a
minimum of 40 hours of comprehensive home inspector instruction or obtained a passing grade on the National Home Inspector
Examination offered by the Examination Board of Professional Home Inspectors® or another Department approved national exam.
For a registration renewal, Home Inspectors are required to provide documentation that they have completed 40 hours of continuing
education over the prior 2 years.
☐ I am enclosing proof that I have completed 40 hours of comprehensive home inspection instruction
☐ I have achieved a passing grade on the National Home Inspector Examination
☐ I am enclosing proof that I have achieved a passing grade on another national examination
☐ I am renewing and am enclosing proof that I have completed 40 hours of continuing education over the prior 2 years
Applicant Signature:
Applicant Printed Name:
Revised: Mar 2020
DLI-ERD-WCR001
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