Private Employment Agency or License - Cessation of Business
Date:
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This will confirm that (Full Name of Agency):
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Formerly located at this address:
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Ceased operating as an applicant fee paid employment agency on or about:
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I understand that I/We must obtain a license from the Labor Commissioner pursant to Section 31-131(c) of the Connecticut General Statues before conducting any future private employment agency business:
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Name:
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First Name
Last Name
Title:
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Submit
Should be Empty: