21 NCAC 50 .1106 PETITION FOR PREDETERMINATION
(a) An individual who wishes to file a petition for a predetermination of whether the individual's criminal history will likely disqualify the individual from obtaining a license from the Board shall submit a petition in writing at the office of the Board.
(b) The petition shall include the petitioner's:
(1) legal name;
(2) mailing, physical, and email addresses;
(3) social security number;
(4) date of birth;
(5) telephone number;
(6) criminal record report prepared no more than 60 days prior to the date of petition by the agency designated by the Board;
(7) written statement describing the circumstances surrounding the commission of the crime(s);
(8) written statement of any rehabilitation efforts;
(9) rehabilitative drug or alcohol treatments;
(10) Certificate of Relief granted pursuant to G.S. 15A-173.2;
(11) affidavits or other written documents, including character references, that the petitioner intends to submit for review;
(12) certification that the this information provided is true and complete;
(13) signature.
(c) The fee for a petition for predetermination shall be forty-five dollars ($45.00).
History Note: Authority G.S. 87-18; 93B-8.1(b6);
Eff. July 1, 2020.