I do not see my school district or charter school listed in Section 8. How do I select the correct restriction?

If the CDS code is not listed under the School District CDS Code, click on the box “Don’t see your School District?” to be able to type the CDS code for the appropriate school the document is to be restricted to. 

I do not see an option to select an Intern Credential. How should this be indicated on the application?

  • For a change of restriction on an Intern credential: Under Section 2 select “Change of Restriction”. In Section 3 select “Other” and type “Intern Restriction Change” in the text field. 
  • For a reactivation of an Intern credential: Under Section 2 select “Other”. In the “Other” field, type “Intern Reactivation”. Then in Section 3 select the Single Subject, Multiple Subject, or Education Specialist.
  • For an extension to an Intern document: Under Section 2 select “Extension by Appeal”. In Section 3 select “Other” and type “Extension to Intern credential” in the text field. 
  • Note- Comments may be added on page 5 that indicates the application is for the Intern credential.

How can the File Date Box be completed?

The individual will need to complete the 41-4 web form in its entirety, generate the PDF, sign the form, and then provide the completed application to the employer or program to complete the File Date Box. 

Can we still complete a 41-4 by hand?

Yes, older versions of the 41-4 completed by hand can still be submitted at this time. However, the Commission strongly encourages everyone to utilize the new web form and the tools it provides to reduce errors, speed up processing, and avoid any unnecessary delays with application submission.

I am an employer and we used to complete portions of the application on behalf of employees and print for applicants to complete and sign. With the web form all sections of the application must be completed for the form to generate. What do you advise?

An application must be completed by the applicant directly. An employing agency should only complete the file box section of an application as the applicant must sign under penalty of perjury that the application in its entirety is correct.

Updated July 20, 2023