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The PES 4012 form is an essential document for engineers and surveyors in Ohio, serving as the continuing professional development (CPD) activity log required for annual registration renewal. It captures all CPD activities pertinent to one's profession, ensuring each entry reflects courses or events that embody technical, ethical, or managerial content. The State Board of Registration for Professional Engineers and Surveyors mandates that professionals accumulate a minimum of fifteen CPD hours each year to maintain their licenses. Importantly, the PES 4012 form does not substitute for documentation such as completion certificates, which remain necessary as outlined by Ohio Revised Code section 4733.151. Furthermore, the form allows for a maximum carryover of 15 CPD hours from the previous year, enabling registered professionals to manage their educational requirements effectively. Comprehensive instructions regarding the Board’s CPD requirements are available on their official website. Properly completing this form is crucial for ensuring compliance and contributing to one's professional growth.

Pes 4012 Example

OHIO’S STATE BOARD OF REGISTRATION FOR PROFESSIONAL ENGINEERS AND SURVEYORS

 

Continuing professional development (CPD) activity log

4012

All CPD activities and courses must be relevant to the practice of engineering or surveying and must include technical, ethical or managerial content. This form is required for tracking your CPD hours for Ohio P.E. and P.S. registration annual renewal. This form does not replace copies of your certificates of completion or other documentation required by Ohio Revised Code section 4733.151. Fifteen CPD hours are required for Ohio registration renewal. A maximum carryover of 15 CPD hours are allowed per year. For information about the Board’s CPD requirements, go to our website at www.peps.ohio.gov/ContinuingEducation.aspx.

YOUR OHIO P.E., P.S. REGISTERED NAME AS IT IS ON YOUR LICENSE

 

 

P.E. NUMBER

 

 

P.S. NUMBER

FOR CALENDAR YEAR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

 

0

 

0

 

9

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE

SPONSOR /

 

 

 

LOCATION:

ACTIVITY TITLE,

 

 

 

 

 

CPD

DOCUMENTATION

[MM/DD]

PROVIDER

 

 

ADDRESS, CITY, STATE, ZIP

DESCRIPTION

INSTRUCTOR

 

EARNED

 

 

RECEIVED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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2008 CPD

 

TOTAL

TOTAL

 

The CPD credits listed herein are true and correct, and accurately state the professional development hours I have earned.

CARRIED OVER

 

2009 CPD

CPD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(MAXIMUM 15)

 

EARNED

EARNED

 

SIGNATURE

 

 

 

 

 

 

 

 

DATE SIGNED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State Board of Registration for Professional Engineers and Surveyors

50 West Broad Street, Suite 1820 • Columbus, Ohio 43215-5905

VOICE (614) 466-3651FAX (614) 728-3059U.S. TOLL FREE (877) 644-6364 (877) OHIO ENG EMAIL pes.board@pes.ohio.gov • WEB www.peps.ohio.gov

PES 4012 (Rev. 01/2009)

Form Characteristics

Fact Name Description
Purpose The PES 4012 form is used to track continuing professional development (CPD) hours for Ohio P.E. and P.S. license renewal.
CPD Requirements A total of fifteen CPD hours is required for annual registration renewal in Ohio.
Carryover Policy Licensees may carry over a maximum of 15 CPD hours from the previous year.
Relevance of Activities All CPD activities must be pertinent to engineering or surveying and include technical, ethical, or managerial content.
Documentation The form must be accompanied by copies of certificates of completion or other relevant documentation as required by Ohio Revised Code section 4733.151.
Form Availability Additional details on CPD requirements can be found at the Board's website: www.peps.ohio.gov/ContinuingEducation.aspx.
Contact Information The State Board of Registration for Professional Engineers and Surveyors can be reached at (614) 466-3651 or via email at pes.board@pes.ohio.gov.

Guidelines on Utilizing Pes 4012

After receiving your Pes 4012 form, you'll need to complete it accurately for your professional development tracking. This form helps maintain your qualifications as a professional engineer or surveyor in Ohio. Follow these steps to ensure everything is filled out correctly.

  1. Begin by entering your registered name exactly as it appears on your license.
  2. Fill in your P.E. number and P.S. number in the respective fields.
  3. Specify the calendar year for which you are reporting CPD hours.
  4. List the date of each activity in MM/DD format.
  5. Identify the sponsor or location of each activity.
  6. Provide the activity title along with the CPD documentation for each entry.
  7. Fill in the provider's address, including city, state, and ZIP code.
  8. Write a brief description of each activity you completed.
  9. Include the name of the instructor for each listed activity.
  10. Document the "earned" hours for each activity and the corresponding "from" and "to" dates.
  11. Calculate your total CPD hours for the year and record it in the "2008 CPD TOTAL" box.
  12. Indicate any carryover hours from the previous year in the space provided.
  13. Sign and date the form to certify that the information is true and correct.

Ensure you retain copies of all supporting documentation, such as certificates of completion, alongside this form for your records.

What You Should Know About This Form

What is the PES 4012 form?

The PES 4012 form is used for tracking continuing professional development (CPD) hours required for the renewal of engineering and surveying licenses in Ohio. Completing this form helps ensure you meet the CPD requirements set by the Ohio State Board of Registration for Professional Engineers and Surveyors.

How many CPD hours are required for Ohio registration renewal?

Ohio requires a total of 15 CPD hours for the annual renewal of your registration as a professional engineer or surveyor. Make sure that your CPD activities are relevant to your practice and include technical, ethical, or managerial content.

Can I carry over CPD hours from one year to the next?

You may carry over a maximum of 15 CPD hours from one year to the next. This is beneficial if you accumulate more than the required hours in a given year, allowing you to keep your professional development on track over time.

Do I need to submit certificates of completion along with the PES 4012 form?

Yes, the PES 4012 form does not replace the need for documentation such as certificates of completion or other proof of your CPD activities. You should keep these documents as required by Ohio Revised Code section 4733.151.

Who should I contact for more information about CPD requirements?

For additional details regarding CPD requirements, visit the Ohio State Board’s website at www.peps.ohio.gov/ContinuingEducation.aspx or contact them directly via email at pes.board@pes.ohio.gov.

What information do I need to provide on the PES 4012 form?

You must include your name as registered, P.E. and P.S. numbers, the calendar year, dates of the activities, activity titles, documentation of earned CPD, and instructor details. This information helps ensure accurate tracking of your professional development activities.

How can I verify the accuracy of my CPD hours?

By signing the PES 4012 form, you affirm that the CPD credits listed are true and correct. Keep personal records of your hours and any supporting documentation to back up your claims if needed.

What happens if I do not meet the CPD requirements?

Failure to meet CPD requirements could jeopardize your ability to renew your professional license in Ohio. It’s essential to stay compliant by tracking your hours and submitting all required documentation on time.

Where can I find the PES 4012 form?

The PES 4012 form may be obtained directly from the Ohio State Board of Registration for Professional Engineers and Surveyors website or by contacting their office. Ensure you are using the most up-to-date version of the form for your submission.

Common mistakes

Filling out the PES 4012 form can be a straightforward process, but many individuals make common mistakes that can lead to complications. Understanding these mistakes can help ensure a smoother experience when submitting your continuing professional development (CPD) hours.

One frequent error is not providing the correct name as it appears on your license. This detail is crucial, as any discrepancies may delay the processing of your renewal. Always double-check your registered name before submission.

Another common mistake is failing to document all activity details. Each CPD activity requires specific information, including the date, provider address, and a description. Omissions in these areas can lead to your application being incomplete.

Many also overlook the requirement for a valid CPD documentation. Merely citing training hours without attaching supporting documentation can jeopardize your renewal process. Remember, certificates of completion are necessary to substantiate your claimed hours.

Inaccurate calculations of CPD hours earned can be problematic. Some individuals miscount their hours or misinterpret the maximum carryover rule. Ensure you double-check the totals and understand the limitations on carryover to remain compliant with the rules.

Submitting the form without a signature is yet another mistake. The signature confirms that the information is accurate and complete. Omitting this step can result in the form being rejected and the renewal delayed.

Individuals sometimes neglect to check the deadlines set by the State Board. Submitting the PES 4012 form too close to the renewal deadline can cause added stress and complications. Mark your calendar well in advance to avoid any last-minute issues.

Another issue arises when applicants use outdated forms. Always verify that you are using the most current version of the form. Using an outdated form may result in rejection or processing delays.

Finally, failing to reach out for assistance when needed can be a major oversight. If there are uncertainties about the form or the CPD requirements, consult the Board's website or contact their office directly. Ensuring clarity can prevent future complications.

By avoiding these mistakes, you can ensure that your PES 4012 form is filled out correctly, making your renewal process as smooth as possible.

Documents used along the form

The PES 4012 form is crucial for engineers and surveyors in Ohio as it helps track their Continuing Professional Development (CPD) hours. However, several other forms and documents accompany it to ensure compliance with state regulations and to maintain accurate records of professional development. Below is a brief overview of these essential documents.

  • Certificates of Completion: After completing a CPD activity, participants typically receive a certificate. This document verifies their attendance and completion of the course, serving as proof when submitting the PES 4012 form.
  • Course Description Document: This document outlines the details of the CPD course attended, including the objectives, topics covered, and relevance to the profession. It provides context for the hours claimed on the PES 4012.
  • Provider Information Sheet: When registering for a course, a provider information sheet may be required. This sheet includes details about the organization offering the CPD activity, such as accreditation and contact information.
  • Annual Renewal Application: Engineers and surveyors must submit an annual renewal application to maintain their professional status. This application includes verification of required CPD hours as recorded on the PES 4012 form.
  • Documentation of Carryover Hours: For those who wish to carry over CPD hours into the next cycle, documentation is necessary. This record shows hours earned in previous years that have not yet been applied to the current registration period.
  • Disciplinary Action Records: If applicable, records of any disciplinary actions may need to be included during the renewal process. These documents ensure that all aspects of a professional’s history are considered in maintaining their license.

Maintaining accurate records and understanding the required documentation is essential for engineers and surveyors in Ohio. These forms not only support timely renewal but also promote a culture of ongoing learning and professionalism in the field.

Similar forms

The following documents share similarities with the Pes 4012 form, particularly regarding the tracking of professional development, certification, or regulatory compliance:

  • CPD Activity Log Form – This document serves a similar purpose by recording continuing education hours. Professionals often use it to log activities that maintain their licensure, mirroring the structure found in the Pes 4012.
  • Continuing Education Certificate – Issued upon completion of a course, this certificate provides proof of earned education credits. Like the Pes 4012, it is essential for renewal of professional licenses and may be submitted alongside the activity log.
  • License Renewal Application – This application is filed to renew a professional license. It frequently requires the inclusion of documented CPD hours, which the Pes 4012 form supports by consolidating earned credits.
  • Ethics Training Verification Form – Often required for maintaining licensure, this form documents completion of ethics training. The requirement for documenting specific education aligns with the documentation expectations of the Pes 4012.
  • Professional Development Plan (PDP) – A PDP outlines an individual’s goals for professional growth, often requiring documentation of completed CPD activities. This necessity parallels the reporting function of the Pes 4012, promoting accountability in professional development.

Dos and Don'ts

When filling out the PES 4012 form, attention to detail is crucial. Below are important do's and don'ts to ensure a smooth process.

  • Do verify that all CPD activities listed are relevant to engineering or surveying.
  • Do ensure your name and license numbers match exactly as they appear on your license.
  • Do provide clear and accurate descriptions of your CPD activities.
  • Do keep copies of certificates of completion; this form does not replace them.
  • Do carefully calculate and report your total CPD hours accurately.
  • Don’t leave out any required information, such as date and provider details.
  • Don’t misrepresent or exaggerate the hours you have earned.
  • Don’t forget to check for deadlines related to form submission.
  • Don’t assume that forms can be submitted without verification; check for accuracy.
  • Don’t ignore the maximum carryover rule; only 15 hours can be carried over each year.

Your timely completion of the PES 4012 form is essential. Following these guidelines can help ensure that you meet the requirements for Ohio P.E. and P.S. registration renewal without issues.

Misconceptions

Understanding the PES 4012 form can be challenging, and several misconceptions often arise regarding its purpose and requirements. Here are six common misunderstandings:

  • The PES 4012 is only for engineers. This form is essential for both professional engineers (P.E.) and professional surveyors (P.S.) in Ohio. Both professions are required to submit this form to track their continuing professional development (CPD) hours for registration renewal.
  • Completing the PES 4012 form guarantees registration renewal. While this form tracks your CPD hours, it does not guarantee renewal. Any required certificates or additional documentation must also be submitted as specified by Ohio Revised Code section 4733.151.
  • Only formal courses qualify for CPD hours. While formal courses count, the CPD activities can also include seminars, workshops, and relevant training sessions. Any activity must be directly related to engineering or surveying practice.
  • Once you reach the 15-hour requirement, no carryover is allowed. In fact, Ohio allows a carryover of up to 15 CPD hours from one registration year to the next. This can provide flexibility for professionals who meet their requirements early.
  • You do not need to keep records of CPD activities. This is incorrect. It is essential to maintain documentation for each activity, such as certificates of completion. The PES 4012 form is a summary but should be supported by these records.
  • Submitting the PES 4012 form is the final step in the renewal process. Completion of the form is just one part of the renewal process. All documentation must be submitted, and fees must be paid by the designated deadline for successful renewal of registration.

Awareness of these misconceptions can help ensure that professionals in Ohio navigate their registration requirements with greater ease and accuracy.

Key takeaways

When it comes to filling out the PES 4012 form, keep these key takeaways in mind to ensure a smooth and compliant process for your continuing professional development (CPD) requirements.

  • Relevance is Key: All CPD activities must relate directly to engineering or surveying practices and include important technical, ethical, or managerial content.
  • Document Everything: While the PES 4012 form tracks your CPD hours, remember that it does not replace the need for certificates of completion or other required documents as stated in Ohio Revised Code section 4733.151.
  • Know the Hours: A total of fifteen CPD hours are necessary for Ohio registration renewal. Make sure you’ve met this requirement before submitting your form.
  • Carryover Credits: You are allowed to carry over a maximum of 15 CPD hours to the next year. This can be particularly beneficial if you had a busy year.
  • Validate Your Entries: Before signing the form, double-check that all reported CPD credits are accurate and genuinely reflect the hours earned.

By following these pointers, you can confidently navigate the requirements of the PES 4012 form and ensure your professional development activities align with state mandates. Don’t wait until the last minute—start documenting your hours now!