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Licensee Contact Information Update

TCEQ license holders are required by rule (30 TAC §30.24(l)) to provide up to date contact information to the Occupational Licensing Section. Please fill out the form completely and accurately to inform us of updates to contact information.

Licensee Name Enter your first and last name

Date of Birth Please select date of birth.

Year / Month / Day

License Number(s) Enter your license number(s).

Licensing program ex: Water, Wastewater, Irrigation, CSI, BPAT, MSW, WTS, UST, LPST

Mailing Address Mailing Address Line 1 should include Apartment & Suite Numbers

City

State ex: TX

ZIP Code

County ex: Travis, Williamson, Harris, Bexar

Home Phone Number (xxx)xxx-xxxx

Work Phone Number (xxx)xxx-xxxx

Cell Phone Number (xxx)xxx-xxxx

Work Fax (xxx)xxx-xxxx

Personal Email

Office Email