N.H. Admin. Code § Saf-C 2703.02

Current through Register No. 45, November 7, 2024
Section Saf-C 2703.02 - Application for Hospital Emergency Permit
(a) The department shall furnish application forms for a hospital emergency permit, form DSMV 370, at the Division of Motor Vehicles, 23 Hazen Drive, Concord, N.H. 03305.
(b) Each applicant for a hospital emergency permit shall furnish the following on form DSMV 370 "Application for Hospital Emergency Permit":
(1) Name, address, and date of birth;
(2) Name and address of the hospital in which applicant is employed or affiliated; and
(3) Driver license number and state of issuance.
(c) In addition to the requirements of (b) above, the applicant shall submit an employment certification signed by the hospital administrator pertaining to the applicant's employment status.
(d) The applicant shall sign and date the form.

N.H. Admin. Code § Saf-C 2703.02

#4976, eff 11-14-90; ss and moved by #6174, eff 1-26-96 (from Saf-C 2702), EXPIRED: 1-26-04

New. #8073, eff 4-23-04; ss by #10084, eff 1-31-12

Amended by Volume XLI Number 27, Filed July 8, 2021, Proposed by # 13214A, Effective 6/16/2021, Expires 6/16/2031