N.H. Code Admin. R. Saf-C 2703.02
Application for Hospital Emergency Permit
Effective Jun 16, 2021#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; ss by #13214-A, eff 6-16-21Commissioner, Department of Safety
- (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.
Source. #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; ss by #13214-A, eff 6-16-21