1. (a) All applicants for licensure under RSA 143:10 shall complete and submit to the department, Form ISB APP “Application for Beverage and Bottled Water License” (November2018 Edition), obtained from the department at https://www.dhhs.nh.gov/dphs/fp/beverage/license.htm, affirming and certifying the following:

   “I certify that all information provided in or attached to this application is complete, accurate and up-to-date as of the date specified below. I further certify that there are no willful misrepresentations of the answers to questions herein, and that I have made no omissions with response to any of my answers to the questions presented. I understand that it is my responsibility to immediately notify the Food Protection Section with regard to any changes, corrections or updates to the information provided.”

2. (b) The applicant shall include the following in the application submittal:

   1. (1) Copies of all types of labels to be used in New Hampshire;
   2. (2) Copies of any FDA approval issued relative to labels making claims of medicinal or health giving properties;
   3. (3) Laboratory results of the water analysis required by He-P2102, with the exception of He-P 2102.05 (b) (1) for both the source and the finished product, if the product is bottled water, or source water analysis if the product is a beverage; and
   4. (4) Cash, check, money order, or on-line payment for the applicable fees, in accordance with He-P 2104.04.

Source. #1685, eff 12-21-80; 1930, eff 1-26-82; 2638(E), eff 3-2-84; #3000, eff 4-2-85; #3069, eff 7-23-85; ss by #4658, eff 7-31-89, EXPIRED: 7-31-95 New. #7979, eff 10-22-03; ss by #10012, INTERIM, eff10-22-11, EXPIRES: 4-19-12; ss by #10116, eff 4-19-12, ss by #12680, eff 11-27-18 (formerly He-P 2106.01)