1. (a) Certificate of authorization application forms for land surveying corporations, partnerships, and proprietorships shall be provided by the board upon request.
2. (b) Pursuant to RSA 310-A:65-a, the land surveying company shall submit a completed typewritten application form.

3. (c) The applicant shall provide the following on the application for certificate of authorization form:

   1. (1) Complete name and address of the corporation, partnership, or proprietorship;
   2. (2) Whether the application is for a corporation, partnership, or proprietorship;
   3. (3) Whether the application is new or a renewal;
   4. (4) Certificate of authorization number for renewal applicants;
   5. (5) Name and addresses of officers or partners;
   6. (6) Names, addresses, New Hampshire land surveyor license numbers, statuses of personnel responsible for all land surveying activities and decisions;
   7. (7) The name of a person or persons legally authorized to sign for the corporation, partnership or proprietorship;
   8. (8) Name and e-mail address of a contact person for the firm;
   9. (9) A statement acknowledging that the applicant has provided correct and true statements in the application;
   10. (10) Acknowledgment that the provision of false information in the application is a basis for denial and for disciplinary action by the board; and
   11. (11) Applicant’s signature and date.
4. (d) The completed certificate of authorization application form shall be submitted to the joint board office with the fee specified in Lan 304.01.

Source. #12031, eff 11-1-16 (from Lan 301.06)