N.H. Admin. Code § Env-Sw 316.04

Current through Register No. 37, September 12, 2024

Section Env-Sw 316.04 - Use of Disclosure Forms; Signatures

(a) Disclosure of personal information shall be on a "Personal Disclosure Form" (PDF) dated April 2021.

(b) Disclosure of business information shall be on a "Business Disclosure Form" (BDF) dated April 2021.

(c) Any PDF filed shall be signed and dated by the individual who is the subject of the PDF.

(d) If a PDF is completed by someone other than the individual who is the subject of the PDF, the name, address, and telephone number of the individual who completed the PDF shall be stated on the PDF.

(e) The signature provided pursuant to (c), above, shall constitute a sworn or affirmed statement that:

(1) The signer has made diligent inquiry into all matters addressed in the PDF;

(2) Based on such inquiry, the submitted information is true, complete, and not misleading to the best of the signer's knowledge and belief; and

(3) The signer understands that if any of the statements are false, incomplete, or misleading, then:

a. Processing of the application may be delayed;

b. The permit sought may be denied or revoked; and

c. He or she may be subject to prosecution for false swearing under RSA 641:3 or any successor statute.

(f) The individual who prepares a BDF on behalf of an entity shall complete, sign, and have notarized an "Affidavit of Author", which shall constitute a sworn or affirmed statement that:

(1) The signer is the individual who filled out the attached BDF in the name of the entity that is the subject of the BDF or who directed that the information contained in the BDF be set down therein;

(2) The signer has made diligent inquiry into all matters addressed in the BDF;

(3) Based on such inquiry, the submitted information is true, complete, and not misleading to the best of the individual's knowledge and belief; and

(4) The signer understands that if any of the statements are false, incomplete, or misleading, then:

a. Processing of the application may be delayed;

b. The permit sought may be denied or revoked; and

c. He or she is subject to penalties for false swearing under RSA 641:3 or any successor statute.

(g) Any BDF filed for an entity shall be signed and dated by the individual(s) identified below, as applicable to the legal form of the entity:

(1) If the entity is a corporation, the:

a. President, chairman of the board, or chief executive officer;

b. Secretary; and

c. Treasurer;

(2) If the entity is any type of partnership, each general partner;

(3) If the entity is a sole proprietorship, the owner; and

(4) If the entity is any other business form, the individuals having positions equivalent to a corporation's chief executive officer, secretary, and treasurer.

(h) The signatures provided pursuant to (g), above, shall constitute certification that:

(1) The signer has examined the BDF;

(2) The BDF contains no statement or information the signer knows to be false, incomplete, or misleading; and

(3) The signer understands that if the certification is false, then:

a. Processing of the application may be delayed;

b. The permit sought may be denied or revoked; and

c. He or she is subject to penalties for false swearing under RSA 641:3 or successor statute.

N.H. Admin. Code § Env-Sw 316.04

(see Revision Note at chapter heading for Env-Sw 300) #8462-B, eff 10-28-05

Amended byVolume XXXIV Number 24, Filed June 12, 2014, Proposed by #10595, Effective 7/1/2014, Expires7/1/2024.

Amended by Volume XLII Number 23, Filed June 9, 2022, Proposed by #13386, Effective 5/26/2022, Expires 5/26/2032