To become certified, you may download the Small Business Enterprise Certification Application along with any of the other supporting documentation listed below. All forms listed below may not be required for your firm's application, so please review them carefully before completing and submitting.

SBE Initial Application Form: The SBE Initial Application Form includes a general overview of the SBE Certification Application (for both Instate and Out-of-State Firms), the Application, a Personal Net Worth Statement (PNW), the Affidavit of Certification, Desired Work Locations Sheet and the Certification Document Checklist. All documents within this file must be completed, indicating 'Not Applicable (N/A)' when necessary. Please provide supporting documentation when asked or if necessary.

*Personal Net Worth Statement (PNW) - Is to be completed by all owners comprising 51% ownership or more for the firm at hand. If only one owner makes up 51% or more, then only one (1) PNW Statement needs to be completed, signed and notarized. If one (1) or more owners combined, make up the 51% or more, then those owners who make up that percentage, need to have an individual PNW Statement completed, signed and notarized. Once completed all original forms must be mailed to PennDOT using the information below.

SBE Annual Affidavit: The SBE Annual Affidavit only needs to be completed by firms that have already been certified by PennDOT and are approaching their Yearly Anniversary Date

SBE Notice of Change (NOC) Affidavit: The SBE NOC Affidavit must be reviewed, completed and submitted within thirty (30) calendar days of a change within your firm. Please review the document to see what circumstances are deemed as a 'change' within your firm.

SBE NAICS Code Modification Form: The SBE NAICS Code Modification form should be completed by a firm who wish to expand their certification code(s) prior to the annual affidavit submission. Complete and submit a NAICS Code modification with supporting documents to include contracts & invoices reflecting the firms ability to control the specific scope of work indicated by the NAICS code(s) requested.

Important Note:

All forms are in PDF format and require Adobe Acrobat Reader to view and print. This software is provided free of charge and you may download the latest version by clicking on the 'Get Acrobat Reader' button.

Certification Forms:

To download a form, right-click the form's name and choose 'Save Target As...' then specify the folder where you want to save the form on your local computer.

SBE Initial Application Form

SBE Annual Affidavit

SBE Notice of Change Form

SBE NAICS Code Modification Form

These forms may require a signature, notary and date after printing. Form(s) must be printed and mailed to PennDOT.

Regular Mail Express Mail PennDOT, Bureau of Equal Opportunity P.O. Box 3251 Harrisburg, PA 17105-3251 PennDOT, Bureau of Equal Opportunity Commonwealth Keystone Building 400 North Street, 5 West Harrisburg, PA 17120-0041