Section 172-10-006 - VOLUNTARY SURRENDER OR LIMITATION A credential holder may offer to voluntarily surrender or limit a credential issued by the department. The offer must be in writing and include:
(A) The credential holder's legal name and any other names by which the credential holder is known;(B) The credential holder's complete mailing address;(C) The credential holder's telephone number and e-mail address;(D) The credential(s) and credential number(s) that would be surrendered or limited;(E) The desired time frame for offered surrender or limitation: (iii) Definite period of time (specify);(F) The specific reason for offered surrender or limitation of the credential;(G) Any specific terms and conditions that the credential holder wishes to have the department consider and apply to the offer;(H) An attestation that all the information on the offer is true and complete; and(I) The credential holder's signature and date.172 Neb. Admin. Code, ch. 10, § 006
Adopted effective 6/24/2019