Utah Safety Inspection

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		IMPORTANT Please read: When you click register you will be taken to PayPal to collect payment. YOU ARE NOT REQUIRED TO HAVE OR SIGN-UP FOR A PayPal ACCOUNT. You can select the “Pay with a debit or credit card” option. If you have a PayPal account, feel free to use it.
*Choose Option
*Inspector Number
Station Number
*First Name
Middle Initial
*Last Name
*Address 1
Address 2
*City
*State
*ZIP Code
†Home Phone	- -
†Work Phone	- -
*Drivers License #

*State Issued
*Date of Birth
*E-mail
*Create Password
*Confirm Password
*Safety Inspection License Expiration Date
*Required Field †Must have at least one phone number