N.H. Admin. Code § Saf-C 311.36 - Report of Loss Form

(a) An applicant shall submit the following on the report of loss form:

(1) Licensee's name and telephone number;

(2) Federal employer identification number, if applicable;

(3) Date of loss and number of gallons involved;

(4) Nature of loss;

(5) Type of fuel;

(6) Explanation of loss; and

(7) Preparer's name and title, if other than the licensee.

(b) The applicant shall sign and date the form.

Notes

N.H. Admin. Code § Saf-C 311.36

(See Revision Notes #1 and #2 at chapter heading for Saf-C 300) #10032, eff 11-22-11

Renumbered From Saf-C 311.32 Volume XXXV Number 1, Filed January 8, 2015, Proposed by #10753, Effective 1/1/2015.