Get Agency Certification Form - Arkansas State Library - Library Arkansas

Filling out the Agency Certification Form for the Arkansas State Library is an essential process for agencies looking to deposit rules with the library. This guide will provide you with clear instructions to complete the form accurately and efficiently.

Follow the steps to complete the Agency Certification Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling in the 'Name of Agency' field. Enter the full name of your agency as recognized officially.
3. Complete the 'Division/Department/Office' section with the specific division or department name handling this certification.
4. In the 'Contact Person' field, provide the name of the individual who will serve as the main contact for this submission.
5. Enter the 'Telephone' number where the contact person can be reached for any further inquiries.
6. For the 'Statutory Authority for Promulgating Rules', input the relevant authority that allows the agency to promulgate the rules.
7. Specify the 'Title of Rule' that this certification pertains to. Make sure this title matches the rule documentation.
8. Select the 'Rule Status' from the drop-down menu, indicating whether the rule is new or another status.
9. Enter the 'Date Adopted by Agency' in the format MM/DD/YYYY. This should reflect when the agency officially adopted the rule.
10. Indicate the 'Effective Date' which can be set for 10 days after filing or another specific date if noted.
11. Attach the 'Financial and/or Fiscal Impact Statement' if applicable, ensuring it is complete.
12. In the 'Certification of Authorized Officer' section, ensure the authorized officer signs and dates the form, along with their title.
13. Once all fields are completed, review the form for accuracy. Save your changes, then download, print, or share the completed form as needed.

Complete your Agency Certification Form online today for a smooth submission process.