If you answered “NO” to either question contained in #12, you must send in the following supporting documentation:
“No” response to the age question requires the submission of proof of age in the form of a birth certificate.
“No” response to the US Citizenship question requires submission of a copy of resident alien card, permanent resident card or other official US government issued documentation evidencing legal status in the United States.

If you answered “YES” to question #13 concerning state or federal investigations, you must send in the following supporting documentation:
“Yes” response requires the submission of a written explanation of any pending investigation, identification of the agency conducting such investigation, current status as well as copies of any relevant documentation.

If you answered "YES" to question #14 concerning fines or penalties, you must send in the following supporting documentation:
“Yes” response requires the submission of detailed information as to when, why, and by whom said action was taken. The final disposition of the action must be provided, including official documentation evidencing the satisfaction.

If you answered "YES" to question #15 concerning Arrests, Indictments or Convictions, you must send in the following supporting documentation:
“Yes” response requires the completion of an Arrest and Conviction Form. Additional official documentation showing the final disposition of the matter is also required including such items as evidence of dismissal, judgment of conviction, letter from parole/probation officer on current status, etc.

If you answered "YES" to question #16 concerning license revocation, suspension, denial, or restraint, you must send in the following supporting documentation:
“Yes” response requires detailed information as to when, why, and by whom the action to revoke, deny, suspend or restrain a license or right to engage in this or any other business or profession was taken. The disposition of the action must be provided, including official documentation evidencing the disposition. If the action is still pending, provide the current status and expected resolution date. If the license or right to engage in a business or profession has been reinstated, provide the date of the reinstatement and any official documentation evidencing such reinstatement.

If you answered “YES” to question #17 concerning other licensure by this Department, You must send in the following supporting documentation:
“Yes” response requires copy of other license issued by this Department or written identification of type of license held or previously held and dates of licensure.

If you answered "YES" to question #18 concerning bankruptcy or reorganization, you must send in the following supporting documentation:
“Yes” response requires the submission of a copy of the petition in bankruptcy, date of bankruptcy or reorganization proceedings and a copy of discharge, if applicable. If the bankruptcy was for a business entity with which you were affiliated, please describe in detail your position with that business entity, i.e. officer, stockholder, employee, etc.

If you answered “YES” to question #19 concerning material litigation, you must send in the following supporting documentation:
“Yes” response requires the submission of copies of relevant documents describing the material litigation as well as a written explanation of the litigation’s current status and potential impact on the applicant’s financial condition.

If you answered "YES" to question #20 concerning child support obligation issues, you must send in the following supporting documentation:
“Yes” response requires the submission of copies of official documents evidencing the current status of any such arrest warrant or child support arrearages. |