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Applications and Forms

Notice to All Licensees and License Applicants

The Amended Elevator Safety Act (Public Act 96-0054) signed on July 23, 2009, states that all licenseholders and applicants must submit a photograph with their license application or renewal application. Our database has now been updated to include a photo of each licensee and we are now enforcing this policy. Applications have been updated and are located below. Renewal applications state that a photograph is required along with continuing education documentation. Any application (new or renewal) submitted without a photograph will be returned to the sender. A 2" x 2" passport photograph is required.

Chicago Office:

Springfield Office:

Office of the State Fire Marshal Office of the State Fire Marshal
Division of Elevator Safety Division of Elevator Safety
James R. Thompson Center 1035 Stevenson Drive
100 West Randolph Street, Suite 4-600 Springfield, IL 62703
Chicago, IL 60601  
Phone: 312-814-1325 Phone: 217-785-0969
Fax: 312-814-3459 Fax: 217-782-1062

All applications and forms must be submitted to the Office of the Illinois State Fire Marshal, Elevator Safety Division, Chicago Office. If required the Office will invoice you for the appropriate application fee. Please do NOT send payment with your application. Sending a payment with your application will delay the process. Please allow approximately 4 weeks for application processing.
Thank you.

Complaint Form

Complaint Form, Updated 11/6/08 (PDF, 103KB)

This is the form to be used for filing a complaint with the Division of Elevator Safety. Please complete and fax or mail to the Chicago Office, to the attention of Robert Capuani, Director of Elevator Safety, at SFM.Elevators@illinois.gov

Conveyance Registration / Certificate of Operation

Fax forms will no longer be accepted. Please mail your Applications to the Chicago Office address.

  1. Application for Registration of Conveyance, Updated 10/4/11 (PDF, 149KB)
    Please complete the Registration process and pay invoice BEFORE submitting the Certificate of Operation and inspection report. Registration forms should be mailed to the Chicago Office, Elevator Safety Division.

  2. Application for Certificate of Operation - ANNUAL, Revised 4/18/13 (PDF, 111KB)
    The Application for Certificate of Operation - Annual is to be submitted to the Chicago Office along with a copy of the annual inspection form indicating the conveyance has PASSED inspection.

    NEW!!! - Per Public Act 097-0310 a certificate of operation for each conveyance located at a church, synagogue or other building, structure, or place used primarily for religious worship, that is limited to 2 levels, and is the only conveyance in the building will be issued on a triennial basis.

  3. Application for Certificate of Operation - TRIENNIAL, Revised 10/1/12 (PDF, 114KB)
    The Application for Certificate of Operation - Triennial is to be sent to the Chicago Office along with a copy of the completed inspection form indicating the conveyance has PASSED inspection.


  4. Multiple Conveyance Registration Spreadsheet (XLS, 20KB)
    (You may use the spreadsheet if you have more than 50 conveyances to register at one location. Please note that there are two worksheets to be completed - "Location-Owner Info" and "Object Info." Please contact the Division of Elevator Safety if you have questions.

  5. NEW FORM!!! - Change of Ownership/Contact Information for Registered Conveyances - Created 3/6/12 (PDF, 92Kb)
    Please use this form to submit any changes to the contact information for your registered conveyance.
    This form may be faxed to 312-814-3459.

License Applications

All license applications are to be completed and mailed to the Chicago Office with supporting documentation. Incomplete applications will be denied and returned to the applicant. As stated above, DO NOT SUBMIT PAYMENT WITH YOUR APPLICATION - this only delays the application process.

  1. Application for Contractor License, Updated 01/13/14 (PDF, 105KB)
    This application is for a Contractor or a Limited Contractor license.

  2. Application for Inspection Company License Form, Updated 5/31/12 (PDF, 97KB)

  3. Application for Elevator Inspector License, Updated 5/31/12 (PDF, 95KB)
    Please submit a 2 x 2 passport photograph with application along with supporting documentation.

  4. Application for Mechanic License, Updated 9/28/12 (PDF, 108KB)
    Application is for a Mechanic, Limited Mechanic, or a Temporary Mechanic license. Can also be used for renewal of your license. Please submit a 2 x 2 passport photograph with application along with supporting documentation.

  5. Application for Apprentice/Helper Registration, Updated 3/23/12 (PDF, 95KB)
    Please submit a 2 x 2 passport photograph with application along with supporting documentation.

Permit / Variance Forms

  1. Application for Conveyance Permit, Updated 9/28/12 (PDF, 106KB)
    Please submit the payment fee and supporting documentation with the application to the Chicago Office. (Permit Fee - $400.00; Alteration Fee - $200.00).

  2. Application for Conveyance Variance, Updated 06/30/14 (PDF, 93KB)
    Please submit the payment fee ($300.00) and supporting documentation with the application to the Chicago Office.

Inspection Forms

Forms to be used by inspection companies and inspectors for conveyance inspections.

  1. Elevator Inspection Form Updated 07/31/2014 (PDF, 179KB)

  2. Escalator Inspection Form updated 07/31/2014 (PDF, 174KB)

  3. Platform Inspection Form updated 07/31/2014 (PDF, 176KB)

Installation Out of Service

Installation Placed Out of Service, Updated 6/9/11 (PDF, 139KB)

Procedures to be followed in order to take a conveyance out of service. Information to be sent to the Chicago Office, Elevator Safety Division.

Incident Reporting

Incident Report Form, Updated 2/24/10 (PDF, 211KB)

As mandated by the Elevator Safety Act, an Owner or Lessee of a conveyance MUST report all injuries and any damages over $1,000 to the Division of Elevator Safety before the close of the next business day. Please submit this form to the Chicago Office via fax, email or mail as soon as possible after such incident.