W. Va. Code R. § 32-15-4 - Required Documentation for Waiver of Initial Licensure Fees

4.1. Individuals requesting a waiver of initial licensing fees for low income or military service personnel and their spouses, an applicant shall submit to the Board with the application for initial licensure waiver BoAcu-LIW or BoAcu-MFW form and the appropriate documentation as specified in this section.

4.2. To establish low income eligibility for an 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 documentation of eligibility for:

4.2.1. Temporary Assistance for Needy Families Program;

4.2.2. Medicaid;

4.2.3. Supplemental Nutrition Assistance Program; or

4.2.4. A Federal Tax Return.

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; or

4.3.5. Other official military documentation, determined to be appropriate by the Board, demonstrating the service member's qualifying past or current military service; and

4.3.6. A copy of the marriage certificate with the qualifying service member where applicable, the death certificate of the service member if the surviving spouse is applying for the military family waiver and where applicable a notarized affidavit from the surviving spouse verifying the surviving spouse has not remarried.

4.4. Honorably discharged applicants shall submit to the Board a completed application and a DD-214 form or an NGB-22 form showing the applicant has been honorably discharged from military service.

Notes

W. Va. Code R. § 32-15-4