N.H. Admin. Code § Pari 605.31

Current through Register No. 50, December 12, 2024

Section Pari 605.31 - Application Form for Occupational License for Judge

(a) On a form provided by the commission an applicant for a judge's license under Pari 605.01(a)(14) shall supply the following:

(1) Whether the applicant is applying for a license as a judge selected by the commission, a judge selected by a licensee or a temporary judge;

(2) The year for which the applicant is applying for a license;

(3) The applicant's:

a. Full name;

b. Date of birth;

c. Place of birth;

d. Social security number pursuant to RSA 161-B:11, VI-a and (b) below;

e. Residential street address;

f. Residential mailing address, if different from the street address;

g. Residential telephone number; and

h. Personal e-mail address;

(4) A description of the applicant, including the applicant's:

a. Age;

b. Gender;

c. Height;

d. Weight;

e. Hair color; and

f. Eye color;

(5) Whether the applicant is married or single;

(6) Whether or not the applicant is a citizen of the United States;

(7) If the applicant is not a citizen of the United States, the name of the nation in which the individual holds citizenship and a description of the documentation possessed by the applicant relative to his or her presence in the United States, together with any identifying numbers assigned to that documentation;

(8) The name, address and telephone number of the applicant's present employer, if any;

(9) The title of the applicant's current job;

(10) The street address of the applicant's principal place of business, if different from the applicant's residential address and address of the applicant's employer;

(11) The mailing address of the applicant's principal place of business, if different from other addresses;

(12) The applicant's business e-mail address;

(13) The name, address, telephone number and relationship of the applicant's nearest living relative;

(14) Whether or not the applicant is able to perform those duties of a judge set forth in Pari 605.58;

(15) Whether or not, within the past 10 years, the applicant has been convicted of or pleaded guilty, as an adult in any jurisdiction, to any felony, which has not been annulled;

(16) If the answer to (15) above is yes:

a. A description of each felony;

b. The date of each conviction or guilty plea;

c. The name and location of the court where the applicant was convicted or pleaded guilty; and

d. A description of each sentence imposed;

(17) Whether or not, within the past 10 years, the applicant has been convicted of or pleaded guilty, in any jurisdiction, to violation of any law relative to gaming or gambling laws or law relating to cruelty to animals, which has not been annulled;

(18) If the answer to question (17) is yes:

a. A description of each offense;

b. The date of each conviction or guilty plea;

c. The name and location of each court where the applicant was convicted or pleaded guilty; and

d. A description of each sentence imposed;

(19) Whether or not, within the past 2 years, the applicant has been convicted of or pleaded guilty, as an adult in any jurisdiction, to any misdemeanor involving a controlled substance which has not been annulled which.

(20) If the answer to (19) above is yes:

a. A description of each misdemeanor;

b. The date of each conviction or guilty plea;

c. The name and location of each court where the applicant was convicted or pleaded guilty; and

d. A description of each sentence imposed;

(21) Whether or not the applicant is currently subject to the revocation or suspension of a license or occupational license relating to pari-mutuel wagering, greyhound racing or horse racing in this or any other jurisdiction;

(22) If the answer to question (21) is yes:

a. The jurisdiction in which each suspension or revocation occurred;

b. The date of each revocation or suspension; and

c. A description of the terms of each revocation or suspension;

(23) Whether or not the applicant currently does not hold a license or occupational license relating to pari-mutuel wagering, greyhound racing or horse racing issued in this or any other jurisdiction because such license or occupational license was voluntarily surrendered while a proceeding was pending against the applicant for alleged misconduct;

(24) If the answer to (23) above is yes:

a. The jurisdiction in which the surrender was made;

b. The date of the surrender; and

c. A description of the alleged misconduct;

(25) Whether or not the applicant is currently subject to exclusion from any premises at which horse racing, greyhound racing or pari-mutuel wagering is held;

(26) If the answer to (25) above is yes:

a. The jurisdiction imposing the exclusion;

b. The date and terms of the exclusion; and

c. The reason for such exclusion;

(27) Whether or not the applicant is currently subject to a determination that he or she is ineligible to engage in the racing or training of any horse or greyhound, or to engage in pari-mutuel wagering, as the result of misconduct in this or any other jurisdiction;

(28) If the answer to (27) above is yes:

a. The jurisdiction making the determination;

b. The date of the determination; and

c. The reason for the determination;

(29) Whether or nor the applicant has ever owned, operated or been associated in any way with any illegal gambling enterprise;

(30) Whether or not the applicant has previously been licensed by the commission and, if so:

a. The type of license held; and

b. The year or years of such licensure;

(31) Whether or not the applicant has previously been licensed by an agency, commission or other authority in another state or nation that is responsible for issuing licenses relative to pari-mutuel wagering, horse racing or greyhound racing and, if so:

a. The name of each jurisdiction in which a license was held;

b. Each type of license held; and

c. The year or years of such license or licenses;

(31) Whether the applicant has successfully served in on-the-job training under the supervision of a person currently or formerly licensed as a judge;

(32) If the answer to (31) above is yes, the dates of on-the-job training and the name or names of the occupational licensee under whom the training was held;

(33) Whether the applicant is accredited by the USTA or ARCI and, if so, the applicant's ARCI number or a list of USTA licenses;

(34) Whether or not the applicant has vision of at least 20/40 in both eyes, or vision that is corrected to 20/40 in both eyes;

(35) The applicant's signature on a statement preprinted on the form stating that:

a. The applicant agrees to abide by the rules of the commission and the laws of the State of New Hampshire relative to greyhound racing, horse racing and pari-mutuel wagering;

b. The information provided on the application form is true, accurate and complete; and

c. The applicant acknowledges that, pursuant to RSA 641:3, making a false statement on this application form is punishable as a crime; and

(36) The date of the signature described in (35) above.

(b) The occupational license application shall contain the following notice regarding the requirement to provide the applicant's social security number as required by (a)(3)d. above:

"The commission will deny your occupational license if you refuse to submit your social security number (SSN). Your professional license will not display your SSN and your SSN will not be made available to the public.

The commission is required to obtain your SSN for the purpose of child support enforcement and in compliance with RSA 161-B:11. This collection of your SSN is mandatory."

N.H. Admin. Code § Pari 605.31

#8605, eff 4-12-06