CertTEC Work Verification Form for Recertification
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To request recertification, please complete and submit this form to CertTEC.
Section A should be completed by the person requestingrecertification.
Section B should be completed by the person validating work verification
(i.e., Supervisor, Manager, or Human ResourcesRepresentative).
Information on how to submit form and payment is located in Section C.
**All fields must be completed for Recertification request to be processed**

Section A


Section B

The following section to be completed by person providing work verification
(Supervisor, Manager, or Human Resource Representative)

Section C

$10 for electronic version of certificate sent by email
$25 for hard copy of certificate and/or ID card sent by mail
Completed form and check payment can be submitted to:
SpaceTEC Partners, Inc.
379 Cheney Hwy.
PMB 207
Titusville, FL.32780
If paying through PayPal: Scan and email form to info@certtec.com
PayPal payments can be made at:
Any questions, please contact CertTEC staff at (321) 567-5193

The following section to be completed by CertTEC staff.