Get Variance Request Form.02.2013.doc - Board Of Behavioral Health ...

Filling out the Variance Request Form accurately is crucial for ensuring your request is reviewed in a timely manner. This guide will provide step-by-step instructions to help you navigate each section of the form effectively.

Follow the steps to complete your variance request form successfully.

1. Click the ‘Get Form’ button to obtain the Variance Request Form.02.2013.doc and open it in an editor.
2. Begin by providing your personal information in the designated fields. This includes your name, license number (if applicable), mailing address, and telephone number. Ensure that all information is complete and legible.
3. Next, cite the specific rule number and title from which you are requesting the variance. This information is essential for the Board to understand the context of your request.
4. Describe your variance request thoroughly. Specify whether you are seeking a waiver of the rule or need permission to comply in alternate ways. Include the scope and duration of the request, if applicable.
5. State the reasons that justify your variance request. Your explanation should align with the standards noted in Minn. Stat. §14.055, as this will be used by the Board to evaluate your application.
6. If there are individuals who may be adversely affected by your request, provide their names, addresses, and telephone numbers in the respective section.
7. Sign and date the form at the bottom. By signing, you attest that the information is accurate and complete.
8. Finally, ensure the completed form is saved. You can then download, print, or share your request as needed. Remember to submit the form, along with the $10 processing fee, to the Board office at least seven working days before the meeting.

Begin filling out your Variance Request Form online today to ensure prompt processing of your request.