Section 178-10-004 - INITIAL CREDENTIAL004.01 Qualifications To receive a credential to practice as a licensee under the Act, an individual must meet the following qualifications:
1.Age and Good Character: Be at least 19 years old and of good character;2.Citizenship/Resident Information: Be a citizen of the United States, an alien lawfully admitted into the United States for permanent residence under the Immigration and Nationality Act (INA) and who is eligible for a credential under the Uniform Credentialing Act, or a nonimmigrant whose visa for entry, or application for visa for entry, is related to employment as a credential holder in the United States.3.Examination: Pass the examination(s) for licensure prescribed by the Board unless the person qualifies for a temporary hardship license as provided in 178 NAC 10-005.08;4. Otherwise comply with the Act and all standards, rules and regulations adopted and promulgated pursuant to the Act; and5. For water well and/or pump installation contractors, furnish proof to the Department that there is in force a policy of public liability and property damage insurance issued to the applicant in at least the sum of $100,000.00.004.02 Application To apply for a credential to practice as a licensee under the Act, an individual must submit a complete application to the Department. A complete application includes all required documentation, the required fee, and a written application. The applicant may obtain an application from the Department or construct an application that must contain the following information:
1.Written Application: An individual may apply for 1 or more licenses under a single application. The Department issues licenses to individuals for any category or combination of categories for which they have passed any required examination(s) and otherwise meet the requirements of the Act and 178 NAC 10. a. Personal Information: (1) The legal name of the applicant, maiden name (if applicable), and any other names by which the applicant is known;(2) Date of birth (month, day, and year);(3) Place of birth (city and state or country if not born in the United States);(4) Mailing address (street, rural route, or post office address; and city, state, and zip code, or country information);(5) The applicant's: (a) Social Security Number (SSN); or(b) Alien Registration Number ("A#"); or(c) Form I-94 (Arrival-Departure Record) number). Certain applicants may have both a SSN and an A# or I-94 number, and if so, must report both.
(6) The applicant's telephone number including area code;(7) The applicant's e-mail address (optional);(8) The applicant's fax number (optional);(9) Citizenship: The applicant must state that s/he is one of the following: (a) A citizen of the United States;(b) An alien lawfully admitted into the United States for permanent residence under the Immigration and Nationality Act (INA) and who is eligible for a credential under the Uniform Credentialing Act; or(c) A non-immigrant whose visa for entry, or application for visa for entry, is related to employment as a credential holder in the United States;b.Practice Before Application: The applicant must state: (1) That s/he has not practiced as a licensee under the Act in Nebraska before submitting the application; or(2) If s/he has practiced as a licensee under the Act in Nebraska before submitting the application, the actual number of days practiced in Nebraska before submitting the application for a credential and the name and location of practice;c. The type of license desired;d. The name, address and telephone number of the business with which the applicant is/will be engaged;e. All addresses and phone numbers of each business location;f. The nature of the business;g. The person's affiliation with the business;h. The name of all partners in a partnership and the business address and telephone number of each partner;i. If a corporation, the officers and directors of that corporation and the address and telephone number for each office of that corporation within the state.j. If applying for licensure as a water well and/or pump installation contractor, proof of public liability and property damage insurance in the amount of at least $100,000 from the insurance company(ies);k. If the applicant is licensed/certified in any other state or jurisdiction, and whether or not disciplinary action has been taken against the license/certificate;l. Which exam(s) s/he needs to take: the Nebraska exam, the water well monitoring technician exam, the natural resources ground water technician exam, the pump installation exam, and/or the general drilling exam.m. Persons requesting a hardship exemption for licensure must indicate the reasons for the request;n. Persons requesting special arrangements for administering the exam must list the reasons for the request and the special arrangements sought, ando.Attestation: The applicant must attest that: (1) S/he has read the application or has had the application read to him/her;(2) All statements on the application are true and complete;(3) S/he is of good character(4) S/he has not committed any act that would be grounds for denial under 178 NAC 10-009. or if an act(s) was committed, provide an explanation of all such acts; and(5) For the purpose of complying with Neb. Rev. Stat. §§ 4-108 to 4-114, s/he is a citizen of the United States or a qualified alien under the federal Immigration and Nationality Act. The applicant must provide his/her immigration status and alien number, and agree to provide a copy of his/her United States Citizenship and Immigration Services (USCIS) documentation upon request.2.Documentation: The applicant must submit the following documentation with the application: a. Evidence of age, such as: (3) Marriage license that provides date of birth;(4) Transcript that provides date of birth;(5) U.S. State identification card;(6) Military identification; or(7) Other similar documentation;b. Evidence of good character, including: (1)Other Credential Information: If the applicant holds a credential to provide health services, health-related services, or environmental services in Nebraska or in another jurisdiction, the applicant must submit the state, credential number, type of credential, date issued, and expiration date of each credential where the applicant has been or is currently credentialed. The applicant must have the licensing agency submit to the Department a certification of his/her credential;(2)Disciplinary Action: A list of any disciplinary actions taken against the applicant's credential and a copy of the disciplinary action(s), including charges and disposition;(3)Denial: If the applicant was denied a credential or denied the right to take an examination, an explanation of the basis for the denial;(4)Conviction Information: If the applicant has been convicted of a felony or misdemeanor, the applicant must submit to the Department: (a) A list of any misdemeanor or felony convictions;(b) A copy of the court record, which includes charges and disposition;(c) Explanation from the applicant of the events leading to the conviction (what, when, where, why) and a summary of actions the applicant has taken to address behaviors/actions related to the conviction;(d) All addiction/mental health evaluations and proof of treatment, if the conviction involved a drug and/or alcohol related offense and if treatment was obtained and/or required;(e) A letter from the probation officer addressing probationary conditions and current status, if the applicant is currently on probation; and(f) Any other information as requested by the Board/Department;c. Evidence that the applicant is: (2) An alien lawfully admitted into the United States for permanent residence under the Immigration and Nationality Act (INA) who is eligible for a credential under the Uniform Credentialing Act; or(3) A non-immigrant whose visa for entry, or application for visa for entry, is related to employment as a credential holder in the United States; d. Evidence of citizenship, lawful permanent residence, and/or immigration status may include a copy of: (1) A U.S. Passport (unexpired or expired);(2) A birth certificate issued by a state, county, municipal authority or outlying possession of the United States bearing an official seal;(3) An American Indian Card (I-872);(4) A Certificate of Naturalization (N-550 or N-570);(5) A Certificate of Citizenship (N-560 or N-561);(6) Certification of Report of Birth (DS-1350);(7) A Consular Report of Birth Abroad of a Citizen of the United States of America (FS-240);(8) Certification of Birth Abroad (FS-545 or DS-1350);(9) A United States Citizen Identification Card (I-197 or I-179);(10) A Northern Mariana Card (I-873);(11) An Alien Registration Receipt Card (Form I-551, otherwise known as a "Green Card");(12) An unexpired foreign passport with an unexpired Temporary I-551 stamp bearing the same name as the passport;(13) A document showing an Alien Registration Number ("A#") with visa status; or(14) A Form I-94 (Arrival-Departure Record) with visa status;(15) A request for special accommodations, if special testing accommodations are needed by the applicant;(16) Any other documentation as requested by the Board/Department; and3.Fee: The applicant must submit the required license fee (See 178 NAC 11) along with the application and all required documentation.004.03 Department Review The Department will act within 150 days upon all completed applications for initial credentialing.
004.04 Denial of Initial Credential If an applicant for an initial credential does not meet all of the requirements for a credential, the Department will deny issuance of a credential. If the applicant is found to have committed any act which would be grounds for denial of a credential as listed in 178 NAC 10-009, the Department may deny issuance of a credential. To deny a credential, the Department will notify the applicant in writing of the denial and the reasons for the determination. The denial will become final 30 days after mailing the notice unless the applicant, within that 30-day period, requests a hearing in writing. The hearing will be conducted in accordance with the Administrative Procedure Act and 184 NAC 1, the Department's Rules of Practice and Procedure for Administrative Hearings.
004.05 Withdrawn Applications An applicant for a credential who withdraws his/her application or whose application is rejected by the Department prior to administration of the examination will be allowed the return of his/her fee, except for a $25 administrative fee to be retained by the Department.
004.06 Practice Prior to Credential An individual who practices as a licensee under the Act prior to issuance of a credential is subject to assessment of an administrative penalty under 178 NAC 10-012 or such other action as provided in the statutes and regulations governing the credential.
004.07 Confidentiality Social Security Numbers obtained under this section are not public information but may be shared by the Department for administrative purposes if necessary and only under appropriate circumstances to ensure against any unauthorized access to this information.
004.08 Address Information Each credential holder must notify the Department of any change to the address of record.
004.09 Non-English Documents Any documents written in a language other than English must be accompanied by a complete translation into the English language. The translation must be an original document and contain the notarized signature of the translator. An individual may not translate his/her own documents.
178 Neb. Admin. Code, ch. 10, § 004