Section Pari 605.19 - Supplemental Application Form for Harness Patrol JudgeOn a form provided by the commission, an applicant for an occupational license as a harness patrol judge shall, in addition to the application form specified in Pari 605.05, supply the following:
(a) The name of the applicant as it appears on the form specified in Pari 605.05;(b) Whether or not the applicant is a member of the USTA, and if so, the applicant's membership number and expiration date;(c) Whether or not the applicant is licensed by the USTA for the calendar year being applied for;(d) A list of all USTA licenses and years held by the applicant for the most recent 3 years of licensure;(e) The name, address and telephone number of the person, corporation or association licensed under RSA 284:15 recommending the applicant for occupational licensure;(f) Whether o r not the applicant has vision which is 20/40 in both eyes or is corrected to 20/40 in both eyes;(g) The applicant's signature on the statement set forth in Pari 605.28; and(h) The date of the signature described in (g) above.N.H. Admin. Code § Pari 605.19