111—5.3(17A) Intervention.

1. 5.3(1)  Nondiscretionary intervention. Persons who qualify under any applicable provision of law as an intervenor and who file a petition for intervention within 15 working days of the filing of a petition for declaratory order and before the 30-day time period for department action under rule 111— 5.8(17A) shall be allowed to intervene in a proceeding for a declaratory order.
2. 5.3(2)  Discretionary intervention. Any person who files a petition for intervention at any time prior to the issuance of an order may be allowed to intervene in a proceeding for a declaratory order at the discretion of the department.

3. 5.3(3)  Filing and form of petition for intervention. A petition for intervention shall be filed at the administrative office. A petition is deemed filed when it is received by that office. The department shall provide the petitioner with a file-stamped copy of the petition for intervention if the petitioner provides an extra copy for this purpose. A petition for intervention must be typewritten or legibly handwritten in ink and should substantially conform to the following form:

   1. 1. Facts supporting the intervenor’s standing and qualifications for intervention.
   2. 2. The answers urged by the intervenor to the question or questions presented and a summary of the reasons urged in support of those answers.
   3. 3. Reasons for requesting intervention and disclosure of the intervenor’s interest in the outcome.
   4. 4. A statement indicating whether the intervenor is currently a party to any proceeding involving the questions at issue and whether, to the intervenor’s knowledge, those questions have been decided by, are pending determination by, or are under investigation by any governmental entity.
   5. 5. The names and addresses of any additional persons, or a description of any additional class of persons, known by the intervenor to be affected by, or interested in, the questions presented.

   6. 6. Whether the intervenor consents to be bound by the determination of the matters presented in the declaratory order proceeding.

      The petition must be dated and signed by the intervenor or the intervenor’s representative. It must also include the name, mailing address, and telephone number of the intervenor and intervenor’s representative, and a statement indicating the person to whom communications should be directed.

   BEFORE DEPARTMENT FOR THE BLIND
   Petition by (Name of Original Petitioner) for a Declaratory Order to (Cite provisions of law cited in original petition).	}	PETITION FOR INTERVENTION

   The petition for intervention must provide the following information: