18 NCAC 07J .1305          APPLICATION REQUIREMENTS FOR IPEN PROVIDER KEY INDIVIDUALS

An IPEN provider applicant shall provide to the Department the following information for each key individual identified pursuant to Rule .1304 of this Subchapter:

(1)           the information required by 18 NCAC 07B .0402(1);

(2)           the key individual's position title;

(3)           a nationwide criminal history record for a key individual residing in the United States that:

(a)           includes applicable records from all United States jurisdictions;

(b)           is prepared at the applicant's expense; and

(c)           is issued no more than 90 days before the application date;

(4)           a criminal history record for a key individual residing outside the United States with:

(a)           a nationwide criminal history record from their country of residence; and

(b)           the nationwide criminal history record required by Item (3) of this Rule; and

(5)           a written statement by each key individual certifying under penalty of perjury:

(a)           whether the criminal history record submitted is complete or incomplete; and

(b)           that the key individual has provided the applicant with the information required by 18 NCAC 07B Section .0500, including submission of affidavits of moral character if applicable.

History Note:        Authority G.S. 10B-4; 10B-125(b); 10B-126; 10B-134.15; 10B-134.17; 10B-134.19; 10B-134.21; 10B-134.23;

Eff. July 1, 2025.