What is the purpose of the CC0511 form?
The CC0511 form, known as the Boiler Engineer License Affidavit, is used to verify the experience of an applicant for various boiler engineer licenses in Minnesota. It must be filled out by the applicant's employers to confirm their operating experience in a boiler setting.
Who can complete the CC0511 form?
The form should be completed and signed by the Chief Engineer of the plant where the applicant was employed. If there is no Chief Engineer, a person with a valid Second Class License or higher, or the employer themselves, can sign the affidavit.
What information is required on the form?
Key information includes the applicant's name, the details of the steam or hot water boiler plant where they worked, total horsepower, maximum working pressure, and specific dates of employment. The form needs to be detailed to provide an accurate account of the applicant’s operating experience.
How does the affidavit relate to licensing requirements?
The affidavit serves to demonstrate that the applicant meets the experience requirements set by the state for the specific boiler engineer license being sought. Failure to provide adequate proof of experience can result in delays or denial of the license application.
What happens if false information is provided in the affidavit?
Providing false or misleading information in the CC0511 form can lead to serious consequences. This includes civil penalties of up to $10,000, as well as potential suspension or revocation of licenses for individuals involved in the submission.
Can military or maritime experience be used for this affidavit?
Yes, military or maritime service experience can be counted toward licensing requirements. However, in such cases, you need to submit documents like DD214s instead of filling out the CC0511 form.
Is there a fee associated with submitting the form?
Yes, there is a fee that must be submitted along with your application and completed affidavit. This fee needs to be paid via a check or money order made out to the Department of Labor and Industry. Cash is not accepted.
What should I do if I need assistance with the form?
If you need help or have questions about completing the CC0511 form, you can contact the Minnesota Department of Labor and Industry at (651) 284-5031. They can provide guidance and answer any specific inquiries you may have.
How should I submit the completed CC0511 form?
The completed form should be notarized, then mailed to the Minnesota Department of Labor and Industry with your application and fee. It is important to keep a copy for your personal records, as no refunds are given for fees paid.
When does the information on the form become public?
While your application is pending, most information on the CC0511 form is considered private data. Once you receive your license, the data becomes public and will be part of the agency's permanent records.