REQUEST FOR ANNUAL
PERMIT DUES REDUCTION
Declaration by Chief Operating Officer or his Authorized Designate for Existing Permit Holder

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Permit Holder: 
(Company Name)
(Permit No.)
 
I, ____________________________________________________occupy the position of  
___________________________________________________________________________  
in the Permit Holder firm. In that position I have authority and undertake to maintain an organization in which the practice of the profession (s) for which the above Permit Holder is authorized to practice, can be conducted in accordance with The Engineering, Geological and Geophysical Professions Act and Regulations.

I hereby apply for a 50% reduction of the annual permit dues payable by the Permit Holder for the invoiced billing year and declare:
  • The Permit Holder has only one Professional Engineer, Professional Geologist, Professional Geophysicist or Registered Professional Technologist as a full time employee or member of the firm, and

  • The gross revenues of the firm did not exceed $250,000.00 in the last 12 months.

I declare the above statements to be true, complete and accurate to the best of my knowledge and have enclosed a payment of 50% of the Permit to Practice dues.

 
(Signature)

(Date)

Revised December 2000