W. Va. Code R. § 19-15-4 - Required Documentation for Waiver of Initial Licensure Fees

4.1. Individuals requesting a waiver of initial licensure fees for low income or military service personnel and their spouses, shall submit with the application for licensure the initial licensure waiver RN-LIW or RN-MFW form and the appropriate documentation as specified in this section.
4.2. To establish low income eligibility for the initial licensing fee waiver, an applicant shall submit to the Board evidence that the adjusted gross income of the household of the applicant is below 130% of the federal poverty level by submitting a Federal Tax Return or documentation of eligibility for:
4.2.1. Temporary Assistance for Needy Families Program;
4.2.2. Medicaid; or
4.2.3. Supplemental Nutrition Assistance Program;
4.3. To establish military family eligibility for the initial licensing fee waiver, an applicant shall submit to the Board proof of qualifying military service and proof of eligibility as a qualifying spouse or surviving spouse, as follows:
4.3.1. A service members DD-214 form;
4.3.2. A service members NGB-22 form;
4.3.3. A service members DD-1300 form; or
4.3.4. A copy of their current military orders; and
4.3.5. A copy of the marriage certificate with the qualifying service member and, where applicable, the death certificate of the service member if the surviving spouse is requesting the military family waiver.
4.4. Honorably discharged applicants shall submit a completed application, and a DD-214 form or an NGB-22 form showing the applicant has been an honorably discharged from military service.

Notes

W. Va. Code R. § 19-15-4

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