Form Cr-688-001 - Application For Certification As A Court Reporter
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1
2BUSINESS AND PROFESSIONS DIVISION
STATE OF WASHINGTON
STATE OF WASHINGTON
COURT REPORTER SECTION
Department of
Department of
P.O. BOX 9649
OLYMPIA, WA 98507-9649
FOR VALIDATION ONLY
APPLICATION FOR CERTIFICATION
AS A
COURT REPORTER
FEE $130.00 Make remittance payable to the Washington State Treasurer
PLEASE TYPE OR PRINT CLEARLY
001-070-299-0006
Application type – check one
Original application through Washington State examination.
Reapplication through Washington State reexamination. Date of last exam __________________________
Application using National Court Reporters Association designation.
Name of designation ________________________________________________________________________
Application using National Stenomask Verbatim Reporters Association designation.
Name of designation ________________________________________________________________________
Applicant information
APPLICANT NAME
Last
First
Middle
PO BOX OR STREET ADDRESS
CITY
STATE
ZIP
COUNTY
DAYTIME TELEPHONE NUMBER
STATE OF RESIDENCY
DATE OF BIRTH (mo/da/yy)
CITY AND STATE OF BIRTH
SEX
SOCIAL SECURITY NUMBER
BUSINESS TELEPHONE NUMBER
F
M
BUSINESS NAME
BUSINESS PO BOX/STREET ADDRESS
CITY
STATE
ZIP
COUNTY
WASHINGTON CORPORATION NUMBER (if applicable)
WASHINGTON REVENUE TAX NUMBER/UNIFIED BUSINESS IDENTIFIER
TYPE OF BUSINESS (check one)
Sole Proprietor
Partnership
Corporation
If you checked partnership or corporation, attach one copy of the partnership agreement or the current corporation document.
For office use only
Comments
The Department of Licensing has a policy of providing equal access to its services. If
you need special accommodation, please call (360) 753-1061 or TDD (360) 586-2788.
CR-688-001 CT. REPT. APP. (R/8/98)M/W Page 1 of 2
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Parent category: Legal