NOTICE. NEW PROCEDURES FOR OBTAINING AGENCY ISSUED LICENSES/CERTIFICATIONS Effective November 1, 2007

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Department of Environmental Quality NOTICE NEW PROCEDURES FOR OBTAINING AGENCY ISSUED LICENSES/CERTIFICATIONS Effective November 1, 2007 In order to comply with Oklahoma s new immigration law, 56 Okla. Stat. 71, the Oklahoma Department of Environmental Quality has established the following new procedures for an individual to obtain an agency-issued license/certification. A. In order to obtain a license/certification or to renew an existing license/certification, the documentation requested in Sections C and E, including a signed Affidavit Regarding Citizenship, is required. In the absence of the required documentation, citizenship and immigration status cannot be determined and applicants may not be eligible for the license/certification for which they are applying. B. The Department of Environmental Quality will have available notary public services for the Affidavit Regarding Citizenship at no cost to the applicant at the main office located at 707 N. Robinson, Oklahoma City, Oklahoma 73101 during regular business hours (8:00 a.m. 4:30 p.m. Monday through Friday, except holidays). C. The following documents must be provided to the agency with the relevant license/certification application in order to establish eligibility: ALL U.S. CITIZENS 1. A signed and notarized Affidavit Regarding Citizenship (see attached affidavit) ALL NON-U.S. CITIZENS: If you are not a U.S. Citizen, but are a qualified alien under the federal Immigration and Nationality Act and are lawfully present in the U.S. to work, please provide one of the documents listed in Section E, along with the Affidavit Regarding Citizenship. D. The Oklahoma Department of Environmental Quality participates in the Systematic Alien Verification for Entitlements (SAVE) Program, which is an intergovernmental informationsharing initiative designed to aid in determining a non-citizen applicant s immigration status (lawful presence), and thereby ensuring only eligible non-citizens receive government benefits, such as licenses/certifications. E. The Oklahoma Department of Environmental Quality will only issue licenses/certifications to Qualified Aliens (non-u.s. citizens) who present valid documentary evidence of one (1) of the following: Unexpired foreign passport, with I-551 stamp, or attached Form I-94 indicating unexpired employment authorization; Permanent Resident Card or Alien Registration Receipt Card with photograph (Form I-151, or I-551); Unexpired Temporary Resident Card (Form I-688); Unexpired Employment Authorization Card (Form I-688A)

Unexpired Reentry Permit (Form I-327); Unexpired Refugee Travel Document (Form I-571); Unexpired Employment Authorization Document issued by Department of Homeland Security ( DHS ) containing a photograph (Form I-688B); Valid unexpired immigrant or non-immigrant visa status for admission into the United States; Pending or approved application for asylum in the United States; Pending or approved application for temporary protected status in the United States; Approved deferred action status (Aliens whose deportation is being withheld under (1) 243(h) of the Immigration and Nationality Act ( INA ) as in effect prior to April 1, 1997 or (2) 241(b)(3) of the INA; Pending application for adjustment of status to legal permanent resident or conditional resident status. (Aliens granted conditional entry under 2039 (a)(7) of the INA before April 1, 1980). (Upon approval, the applicant may be issued a temporary license/certification for the period of time of the authorized stay in the U.S., or if there is no definite end to the period of authorized stay, then for period of one (1) year); Cuban and Haitian Entrants, as defined in 501(e) of the Refugee Education Assistance Act of 1980; Aliens granted parole for at least one year under 212(d)(5) of the INA; Battered aliens, who meet the conditions set forth in 431(c) of Personal Responsibility and Work Opportunity Reconciliation Act ( PRWORA ) as added by 501 of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, P.L. 104-208 (IIRIRA), and amended by 5571 of the Balanced Budget Act of 1997, P.L. 105-33 (BBA), and 1508 of the Violence against Women Act of 2000, P.L. 106-386. Section 431(c) of PRWORA, as amended, is codified at 8 U.S.C. 1641(c); Victims of a severe form of trafficking, in accordance with 107(b)(1) of the Trafficking Victims Protection Act of 2000, P.L. 106-386. F. Complying with the above requirements does not guarantee issuance of a license/certification. Applicants must still satisfy all other required qualifications of the respective licenses/certifications for which they are applying. G. RENEWALS: Effective November 1, 2007, all applicants will be required to present the documentation listed in Sections C and E to establish eligibility. All licenses/certifications may be renewed upon expiration by, in addition to satisfying any other preconditions required by the particular license/certification, mailing a renewal application and any applicable renewal fee. For renewal applicants that have already demonstrated citizenship by satisfying the requirements set forth in Section C above in his/her original application or a prior renewal application, the applicant shall not be required to resubmit such documentation. For renewal applicants that identify themselves as a qualified alien lawfully present in the Affidavit Regarding Citizenship, the documents listed in Section E must be resubmitted to the Oklahoma Department of Environmental Quality with the renewal application in order to demonstrate that the applicant s lawful status has not changed.

3 Department of Environmental Quality AFFIDAVIT REGARDING CITIZENSHIP I, swear under a penalty of perjury, that I am a United States citizen; or a qualified alien lawfully present in the United States, and I authorize the United States Department of Homeland Security to release my citizenship and immigration status to the Oklahoma Department of Environmental Quality in order to be eligible to receive the benefit/license/certification for which I am applying* License/certification Applicant * Any person who knowingly and willfully makes a false, fictitious, or fraudulent statement or representation in this affidavit shall be subject to criminal penalties applicable in the State of Oklahoma for fraudulently obtaining a public assistance program benefit (a license/certification). If the affidavit constitutes a false claim of U.S. citizenship under 18 U.S.C. Section 911, a complaint will be filed by the Oklahoma Department of Environmental Quality with the United States Attorney for the applicable district based upon the venue in which the affidavit was executed. State of ) ) ss: County of ) ACKNOWLEDGEMENT Subscribed and sworn to before me this day of, 200. Notary Public My Commission expires:

4 TEMPORARY WATER AND WASTEWATER CERTIFICATION APPLICATION Project ID 292010911 PLEASE RETURN APPLICATION TO: Department of Environmental Quality Financial & Human Resources PO Box 2036 Oklahoma City, OK 73101-2036 Fax #: 405-702-7120 Name-Last: First: MI: Address City State Zip Social Security # Birthdate Home Phone Job Title Type of Work Performed Do you supervise other operators or helpers? Employer Address City State Zip Office Phone Employer s Water Facility ID# Employer s Wastewater Facility ID# If you have held a temporary Oklahoma water and/or wastewater license within the last five years, you are not eligible to apply at this time. Temporary license fees are $62.00 per license applied for and must be submitted with your application. Application must be submitted on a current form. Please indicate below which you are applying for: ( ) Temporary Water Works 100841 ( ) Temporary Wastewater Works 100131 The following information is for the name of the permanently certified operator who will supervise your work as a water and/or wastewater works operator during the period in which you are not permanently certified. Name Address City State Zip Water License # Wastewater License # I Certify that I have agreed to train, advise or supervise this applicant s work as a water and/or wastewater operator and will notify the Department of Environmental Quality if my services are terminated prior to the applicant receiving permanent operator status. Supervisor s Signature Date Signed

5 Education: Highest grade or degree completed Experience: List your experience in water and/or wastewater systems operations or maintenance: Describe your duties in detail: Statement of Understanding: I hereby certify under penalty of law that this application contains no willful or negligent misrepresentation or falsification and that all information is true, accurate and complete. I understand that any misrepresentation or falsification may result in rejection of my application for temporary certification. I further understand that if issued a temporary operator certificate, it is not renewable and a new temporary certificate cannot be obtained for at least five (5) years. Therefore, if I am to continue working as a water or wastewater works operator I must qualify for and pass the proper written examination for permanent certification before expiration of my temporary certificate (s). I further understand that this application must be signed by a permanently certified operator who will be giving general supervision of my work as a water and/or wastewater operator. I agree to notify you if his services are terminated before I can obtain the proper permanent certification. Signature of Applicant Date Employment Began (License will expire 1 year from this date) PLEASE CHOOSE FORM OF PAYMENT APPLICATION CANNOT BE PROCESSED WITHOUT PAYMENT. CHECK ENCLOSED MADE PAYABLE TO DEQ CHECK # MONEY ORDER ENCLOSED MADE PAYABLE TO DEQ MONEY ORDER # PURCHASE ORDER PURCHASE ORDER # CREDIT CARD: MUST BE VISA OR MASTERCARD SIGNATURE: EXPIRATION DATE: CREDIT CARD #: