N.H. Code Admin. R. Elec 401.09 - Renewal Application

The applicant shall supply the following information on the application form for license renewal:

(a) The applicant's full name;

(b) The applicant's employer's address and telephone number;

(c) The applicant's home address, telephone number and e-mail address;

(d) The applicant's employment status;

(e) Whether the applicant has ever been convicted of any felony, that has not been annulled by a court pursuant to RSA 651:5 and if not annulled, the name of the court in which the conviction occurred, the details of the offense and the date of conviction and the sentence imposed.

(f) A statement indicating any disciplinary or legal action brought against the applicant by any licensing/certification board or jurisdiction and if so a description of the incident;

(g) Acknowledgement that, if the applicant provided false information that is discovered after the license is renewed, it shall be a basis for disciplinary action by the board; and

(h) The applicant's signature and date.

Notes

N.H. Code Admin. R. Elec 401.09

#10420, eff 9-25-13