Judicial review of the director's decision to grant or deny a
waiver petition may be taken in accordance with Iowa Code chapter 17A.
Exhibit A Sample Petition (Request) for Waiver
BEFORE THE DEPARTMENT FOR THE BLIND
Petition by (insert name of petitioner) for the waiver of
(insert rule citation) relating to (insert the subject matter).
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PETITION FOR WAIVER
Requests for waiver from a department rule shall include the
following information in the petition for waiver where applicable and
known:
a. Provide petitioner's (person
asking for a waiver) name, address, and telephone number
b. Describe and cite to the specific rule
from which a waiver is requested.
c. Describe the specific waiver requested and
include the exact scope and time period that the waiver will extend.
d Explain the important facts that the
petitioner believes justify a waiver Include in your answer why (1) applying
the rule will result in hardship/injustice to the petitioner; (2) granting a
waiver or variance to the petitioner is consistent with the public interest;
and (3) granting the waiver or variance will not prejudice the substantial
legal rights of any person.
e. Provide
a history of prior contacts between the department and petitioner relating to
the regulated activity, license, or grant that would be affected by the waiver
Include a description of each affected license or grant held by the petitioner,
any notices of violation, contested case hearings, or investigative reports
relating to the regulated activity, license, or grant within the last five
years.
f. Provide a detailed
statement of the impact on any person affected by the granting of a
waiver
g. Provide information known
to the petitioner regarding the department's treatment of similar
cases.
h. Provide the name,
address, and telephone number of any state or federal public agency or
political subdivision which also regulates the activity in question or which
might be affected by the granting of a waiver.
i. Provide the name, address, and telephone
number of any person or entity that would be adversely affected or
disadvantaged by the granting of the waiver
j. Provide the name, address, and telephone
number of any person with knowledge of the relevant or important facts relating
to the requested waiver
k. Provide
signed releases of information authorizing persons with knowledge regarding the
request to furnish the department with information relevant to the waiver.
I hereby attest to the accuracy and truthfulness of the above
information.
__________________ __________
Petitioner's Signature Date
Petitioner should note the following when requesting or
petitioning for a waiver:
1. The
petitioner has the burden of proving to the director that (a) application of
the rule to the petitioner would result in hardship or injustice to the
petitioner; (b) waiver on the basis of the particular circumstances relative to
the petitioner would be consistent with the public interest; (c) waiver in the
specific case would not prejudice the substantial legal rights of any person;
and (d) waiver in the specific case would not have a negative impact on any
person affected by the waiver
2.
The director may request additional information from or request an informal
meeting with the petitioner prior to issuing a ruling granting or denying a
request for waiver
3. All petitions
for waiver must be submitted in writing to the Director, Department for the
Blind, 524 Fourth Street, Des Moines, Iowa 50309-2364. If the petition relates
to a pending contested case, a copy of the petition shall also be filed in the
contested case proceeding.
