Nebraska Administrative Code › Topic - LIQUOR CONTROL COMMISSION › Title 237 - Nebraska Liquor Control Commission › Chapter 1 - PRACTICE AND PROCEDURE › Section 237-1-004 - PETITION: FORM

Current through June 17, 2024
BEFORE THE NEBRASKA LIQUOR CONTROL COMMISSION STATE OF
				  NEBRASKA
In the matter of: Petition For:
_______________________ )
				  ______________________________
_______________________ )
				  ______________________________
_______________________ )
				  ______________________________
(Specify request for promulgation or repeal of rule or for
				  declaratory ruling on)
(Give name & address of petitioner)
				  ___________________________
____________________________
____________________________
____________________________
(Specify statute or rule)
COMES NOW PETITIONER and requests the Nebraska Liquor Control
				  Commission for a(n) (promulgation, amendment or repeal of rule _______ ) or
				  declaratory ruling with respect to the applicability of the aforementioned
				  (specify statute or rule).
The following are statements of facts that shall
				  apply:
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____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
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Petitioner states that the aforementioned (request for
				  promulgation, amendment or repeal of rule) or (declaratory ruling) is needed
				  for the following reason(s):
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
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(Show how an appropriate action of the Commission would be in
				  the best interest of the State of Nebraska or would terminate controversy or
				  uncertainty) Petitioner alleges that the following named persons are the only
				  persons who have or claim any interest, or would be affected by the disposition
				  of this petition:
_________________________________________________________
(Name)
(Address)
(City)
(State)
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
WHEREFORE, petitioner prays that the Nebraska Liquor Control
				  Commission take the following action:
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
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__________________________ ___________________________
(Date) (Signature of Petitioner)