(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.