Section R4-12-210. Application for a Cremationist License

An applicant for a cremationist license shall submit an application packet to the Board that contains all of the following:

1.        An application form provided by the Board, signed and dated by the applicant that contains:

a.         The applicant’s name, mailing address, telephone number, and social security number;

b.        The applicant’s date and place of birth;

c.         Any prior name or alias of the applicant;

d.        The name, address, and telephone number of the cre- matory or funeral establishment employing the applicant, if applicable;

e.         Whether the applicant has ever been convicted of or entered into a plea of no contest to a class 1 or 2 fel- ony, including the information in subsections (1)(f)(i) through (1)(f)(vi) for each felony;

f.         Whether the applicant, within the five years before the date of the application, has been convicted of or entered into a plea of no contest to a felony or to a misdemeanor that is reasonably related to the appli- cant’s proposed area of licensure and the:

i.         Charged felony or misdemeanor;

ii.        Date of conviction;

iii.      Court that has jurisdiction over the felony or misdemeanor;

iv.       Probation  officer’s  name,  address,  and  tele- phone number, if applicable;

v.        A copy of the notice of expungement, if appli- cable; and

vi.       A  copy  of  the  notice  of  restoration  of  civil rights, if applicable;

g.        Whether the applicant, within five years from the date of the application, has committed any act involving dishonesty, fraud, misrepresentation, breach of fiduciary duty, gross negligence, or incom- petence reasonably related to the applicant’s pro- posed area of licensure;

h.        Whether the applicant is currently incarcerated, on community supervision after a period of incarcera- tion in a local, state, or federal penal institution, or on criminal probation;

i.         Whether the applicant, within five years from the date of the application, has had an application for a license, registration, certificate, or endorsement denied or rejected by any state funeral licensing authority and the:

i.         Reason for the denial or rejection,

ii.        Date of the denial or rejection, and

iii.      Name and address of the agency that denied or rejected the application;

j.         Whether the applicant has, within five years from the date of the application, had a license, registra- tion, certificate, or endorsement suspended or revoked by any state funeral licensing authority and the:

i.         Reason for the suspension or revocation,

ii.        Date of the suspension or revocation, and

iii.      Name and address of the state licensing author- ity that suspended or revoked the license;

k.        Whether the applicant has ever surrendered a license, registration, certificate, or endorsement to the Board or any other state funeral licensing author- ity; and

l.         A notarized statement by the applicant verifying that the information on the application is true and cor- rect.

2.        A copy of a certificate of completion of a crematory certi- fication program issued by:

a.         The manufacturer of a retort, or

b.        An accredited organization that provides instruction for crematory operation;

3.        A completed and legible fingerprint card; and

4.        The fee required by the Board under A.R.S. § 32-1309.

Historical Note

New Section made by final rulemaking at 10 A.A.R. 681, effective April 3, 2004 (Supp. 04-1).