Section Saf-C 5909.03 - EMS I and EMS I/C License Application Statement of Certification By signing the EMS I and EMS I/C application form, the applicant shall certify that:
(a) The information provided in the application is complete, truthful, and correct, under the penalties of unsworn falsification pursuant to RSA 641:3;(b) The applicant complies with RSA 153-A and these rules;(c) The applicant understands any material falsification of information shall result in license denial, suspension, or revocation, in accordance with Saf-C 5922.03, Saf-C 5922.04, or Saf-C 5922.05 and may be grounds for a misdemeanor conviction pursuant to RSA 641:3;(d) The applicant has not been convicted or found guilty of an offense pursuant to RSA 153-A:13, I or Saf-C 5922.03(c)(5);(e) The applicant has not been subject to limitation, suspension from, or under revocation or probation of the ability to practice in a health care occupation or voluntarily surrendered a health care license in any state or to any agency authorizing the right to work; and(f) If the applicant is unable to certify compliance with Saf-C 5909.03(b) to Saf-C 5909.03(e) the applicant shall provide official documentation that fully describes the offense, current status, and disposition of the case.N.H. Admin. Code § Saf-C 5909.03
(See Revision Note at chapter heading for Saf-C 5900) #7690, eff 5-21-02, EXPIRED: 5-21-10
New. #9779-A, eff 9-8-10
Amended by Volume XXXIX Number 24, Filed June 13, 2019, Proposed by #12790, Effective 5/24/2019, Expires 5/24/2029.Amended by Number 24, Filed June 13, 2024, Proposed by #13953, Effective 4/30/2024, Expires4/30/2034 (See Revision Note #1 and Revision Note #2 at Chapter heading for Saf-C 5900).