Blank Ohio 4011 D PDF Form

What is the purpose of the Ohio 4011 D form?

The Ohio 4011 D form is designed for the renewal of dual Professional Engineer (P.E.) and Professional Surveyor (P.S.) licenses in Ohio for the 2012-2013 period. It ensures that licensed professionals meet the necessary continuing education requirements and allows them to maintain their licenses without interruption.

What are the fees associated with the Ohio 4011 D form?

The renewal fee for submitting the Ohio 4011 D form is $80. However, if the application is submitted after December 31, 2011, the fee increases to $120. Payment must be made in U.S. funds via check or money order, payable to the Treasurer, State of Ohio.

What are the continuing professional development (CPD) requirements?

Applicants must complete 15 hours of continuing professional development as mandated by Section 4733.151 of the Ohio Revised Code. If an applicant was granted initial registration during the calendar year 2011, they are exempt from this requirement.

Can I use the Ohio 4011 D form for license reinstatement?

No, the Ohio 4011 D form is not intended for license reinstatement. It is strictly for the renewal of licenses. If you need to reinstate a license, you should contact the Board for specific instructions.

What should I do if I have a name or address change?

If you have a name change, you must provide legal documentation to support the change. For an address change, simply fill out the new address on the form. Ensure that all information is accurate to avoid any delays in processing your renewal.

Is it necessary to submit copies of my CPD documentation with the application?

No, you should not submit copies of your continuing professional development documentation with the Ohio 4011 D form. However, you should retain these documents in case of an audit by the Board.

What happens if I answer 'yes' to the felony or moral turpitude question?

If you answer 'yes' to having been convicted of a felony or a crime involving moral turpitude, you must provide additional details, including the date, type of conviction, court, case number, and an explanation. This information is crucial for the Board's review of your application.

How do I submit the Ohio 4011 D form?

To submit the Ohio 4011 D form, complete it thoroughly, sign and date it, and send it along with the appropriate fee. Ensure that your application is postmarked no later than December 31, 2011. Send it to the State Board of Registration for Professional Engineers and Surveyors at the specified address.

Where can I find more information about the CPD requirements?

For more information regarding continuing professional development requirements, audits, and downloading CPD activity logs, visit the Board's website at www.peps.ohio.gov. This resource provides comprehensive details to assist you in fulfilling your renewal obligations.

1. Incomplete Information: Many applicants fail to provide all required personal details, such as their full name, address, and license numbers (P.E. and P.S.). Missing information can delay processing.

2. Incorrect Payment Amount: Applicants often submit the wrong fee. The amount due is $80.00 if submitted by 12/31/2011, and $120.00 after that date. Submitting an incorrect fee can result in rejection of the application.

3. Failure to Meet Continuing Education Requirements: Some individuals do not complete the required 15 continuing professional development hours. If this requirement is not met, the application should not be submitted.

4. Using the Wrong Form: Applicants sometimes use this form for reinstatement instead of renewal. This application is only for P.E. and P.S. renewals for the specified period.

5. Not Providing Legal Documentation for Name Changes: If an applicant has changed their name, they must include legal documentation. Failure to do so can result in processing delays.

When renewing your professional engineering or surveying license in Ohio, you may encounter several other forms and documents that work alongside the Ohio 4011 D form. Understanding these additional requirements can help streamline your renewal process and ensure compliance with state regulations.

• Continuing Professional Development (CPD) Log: This document tracks the professional development hours you've completed. It serves as proof that you meet the ongoing education requirements set by the state.
• Application for Reinstatement: If your license has expired or been revoked, this form is necessary for reinstatement. It outlines the steps and requirements to regain your professional status.
• Change of Address Form: Use this form to officially notify the board of any changes to your address. Keeping your information current is essential for receiving important updates.
• Name Change Documentation: If you've changed your name, you must provide legal documentation, such as a marriage certificate or court order, to update your records with the board.
• Verification of Licensure: This document may be required if you are applying for licensure in another state. It verifies your current license status and any disciplinary actions.
• Background Check Authorization Form: Some applications may require a background check. This form authorizes the board to conduct a criminal background check as part of the renewal process.
• Professional References: You may need to submit a list of professional references who can vouch for your qualifications and ethical conduct in the engineering or surveying field.
• Affidavit of Good Standing: This document certifies that you are in good standing with the board and have met all necessary requirements for renewal.
• Fee Payment Form: Along with your renewal application, this form is used to submit the required fees. It details the payment methods accepted by the board.
• CPD Exemption Request: If you believe you qualify for an exemption from the CPD requirements, this form allows you to formally request that exemption.

By familiarizing yourself with these additional forms and documents, you can navigate the renewal process more efficiently. Always ensure that you have the necessary paperwork completed and submitted on time to avoid any complications with your license renewal.

The Ohio 4011 D form is a specific application for renewing dual professional engineering and surveying licenses. Several other documents serve similar purposes in various professional contexts. Below are six documents that share similarities with the Ohio 4011 D form:

• State License Renewal Form: This document is used by professionals in various fields to renew their licenses, requiring similar personal and professional information to ensure compliance with state regulations.
• Continuing Education Compliance Form: Similar to the Ohio 4011 D, this form verifies that a professional has completed necessary continuing education hours, which is often a requirement for license renewal.
• Professional License Application: This document is utilized when applying for a new professional license. It requires similar information, including personal identification and proof of qualifications.
• Change of Address Notification Form: This form is used to update personal information with a licensing board. Like the Ohio 4011 D, it often requires legal documentation for name changes.
• Reinstatement Application: While the Ohio 4011 D cannot be used for reinstatement, this document serves a similar purpose by allowing individuals to regain their professional licenses after a lapse.
• Ethics Compliance Declaration: This document requires professionals to declare any legal issues that may affect their license status, similar to the questions posed in the Ohio 4011 D regarding criminal convictions.

When filling out the Ohio 4011 D form, it is important to follow specific guidelines to ensure a smooth application process. Below are six recommendations on what to do and what to avoid.

• Do complete all required fields accurately, including your name and address.
• Do submit your application before the deadline of 12/31/2011 to avoid late fees.
• Do verify that you have completed the required 15 continuing professional development hours.
• Do sign and date your application to confirm its accuracy.
• Don't submit copies of your continuing professional development information with the application.
• Don't use this form for reinstatement of your professional license; follow the specific instructions for reinstatement instead.

Misconceptions about the Ohio 4011 D form can lead to confusion and delays in the license renewal process. Here are nine common misconceptions clarified:

1. This form can be used for reinstatement of a license. This is incorrect. The Ohio 4011 D form is strictly for renewal of a professional license and cannot be used for reinstatement.
2. Submitting copies of continuing professional development (CPD) documentation is required. In fact, applicants should not submit copies of their CPD information with the application. It is unnecessary and could complicate the process.
3. Renewal applications can be submitted after the deadline. This is misleading. Applications must be postmarked by the deadline of December 31, 2011, to be considered for renewal without penalties.
4. There are no fees associated with the renewal application. This is false. A fee of $80.00 is due for timely submissions, increasing to $120.00 after the deadline.
5. Changing my address does not require any documentation. This is not true. A legal document is required for any name change, while an address change does not require documentation but must be reported.
6. All applicants must complete 15 CPD hours to renew their license. This is a misconception. Applicants who were granted initial registration during calendar year 2011 are exempt from this requirement.
7. My application will be processed even if I have not completed all requirements. This is incorrect. The renewal is contingent upon the satisfactory completion of all requirements, including CPD hours.
8. I can pay my renewal fee in cash. This is not allowed. Payments must be made via check or money order in U.S. funds. Cash is not accepted.
9. I can submit my application without providing all requested information. This is misleading. The application must be fully completed and accurate. Omitting information can lead to rejection of the application.

Understanding these misconceptions can help ensure a smooth renewal process for Ohio’s professional engineers and surveyors.

When filling out the Ohio 4011 D form for dual P.E. and P.S. license renewal, it is essential to understand the key points to ensure a smooth process. Below are ten important takeaways:

• Online Renewal: For faster processing, consider renewing your license online at www.peps.ohio.gov.
• Application Submission: Do not submit the application if you have not completed the required continuing professional development hours.
• Fees: The renewal fee is $80. If submitted after December 31, 2011, the fee increases to $120.
• Payment Method: Make your check or money order payable in U.S. funds to the Treasurer, State of Ohio. Cash is not accepted.
• Name and Address Changes: If you are changing your name, legal documentation is required. Address changes can be noted on the form.
• Reinstatement: This form cannot be used for reinstatement of a professional license. Contact the Board for specific reinstatement instructions.
• Continuing Professional Development: You must certify that you have completed 15 hours of continuing education, or that you are exempt if registered in 2011.
• Criminal History Disclosure: Be prepared to disclose any felony convictions or disciplinary actions from other jurisdictions since your last renewal.
• Accuracy of Information: Ensure all information is accurate and complete. Incomplete applications may delay processing.
• Submission Deadline: The completed application must be postmarked by December 31, 2011, to avoid late fees.

By keeping these takeaways in mind, you can navigate the renewal process more effectively and avoid unnecessary complications.