Administrative Rules of the State of Montana

1.3.233 MODEL RULE 28 GENERAL PROVISIONS, PUBLIC INSPECTION OF ORDERS AND DECISIONS

(1) The agency must maintain an index of all final orders and decisions in contested cases and declaratory rulings. All final decisions and orders shall be available for public inspection on request. 2-4-623 (6) , MCA. Copies of final decisions and orders must be given to the public on request after payment of the cost of duplication.

APPENDIX OF SAMPLE FORMS

Sample form 1 : Notice of proposed agency action.

BEFORE THE [agency]

OF THE STATE OF MONTANA

In the matter of [description ) NOTICE OF PROPOSED

of proposed agency action] ) AGENCY ACTION

TO: All Concerned Persons

1. The [agency] proposes to [description of agency action; for ex.: amend Model Rules 1.1.101 through 1.1.110, to provide for discovery in administrative proceedings].

2. The [agency] will make reasonable accommodations for persons with disabilities who wish to participate in this action and need an alternative accessible format of this notice. If you require an accommodation, contact [agency] no later than 5:00 p.m. on [date - no requirement specified in MAPA], to advise us of the nature of the accommodation that you need. Please contact [name; address; telephone; TTD number; FAX].

3. Concerned persons may submit data, views or arguments in written form or a request for opportunity to submit data, views or arguments in oral form to [name, address]. To be considered, comments and requests must be received by [date at least 28 days from the day of original notice, 2-4-302(4) , MCA].

(must be signed by:)

By: [authorized person's signature]

[signer's name, title]

[agency]

Sample form 2 : Organizational rule. As an example, this rule describes the organization and functions of a fictitious Department of Natural Resources and Conservation and its various units, including the administratively attached Board of Oil and Gas Conservation. The organizational rule must be dated and signed by the Governor and department head. It should be noted that the administratively attached board is required to submit its own organizational description.

ORGANIZATIONAL RULE . (1) Organization of the Department of Natural Resources and Conservation .

(a) History . The Department of Natural Resources and Conservation was implemented under the Executive Reorganization Act of 1971 by executive order of the governor on December 20, 1971.

(b) Divisions . The department consists of the following five divisions:

(i) Centralized Services Division;

(ii) Water Resources Division;

(iii) Forestry Division;

(iv) Conservation Districts Division; and

(v) Oil and Gas Conservation Division. Attached for administrative purposes - see separate organization description. Each division is headed by an administrator. The first four of these divisions are further broken down into bureaus. (See functional charts.)

(c) Director . The director of the department of natural resources and conservation appointed by the governor heads the department. He is responsible for the administration of the department and its divisions.

(d) Board of Natural Resources and Conservation . The board of natural resources and conservation consists of five members appointed by the governor for four-year terms.

(e) Attached Boards . Attached to the department for administrative purposes is the Board of Oil and Gas Conservation. The board consists of five members appointed by the governor and adopts administrative rules separately from the department of natural resources and conservation.

(f) Advisory Councils . There are two advisory councils advising the department - the State Conservation Commission and the Water Law Advisory Council. These councils have no rulemaking or adjudicating authority.

(2) Functions of Department Divisions .

(a) Centralized Services Division . The centralized services division performs the general fiscal administrative support functions for the department. Its activities include purchasing, information and education, cartography, accounting, budgeting, payroll, personnel, statistics, reports, and records management. This division has no rulemaking or adjudicating functions under the Administrative Procedure Act.

(b) Water Resources Division . The water resources division has the responsibility for the administration of water resources programs of the department. Included in its functions are groundwater administration, field project supervision, preparation of the state water resource plan, river basin studies, hydrology, flood plain management and weather modification administration.

(c) Forestry Division . The forestry division administers the forestry programs of the state government. Its activities include timber sales administration, reforestation, timber stand improvement, hazard reduction, portable sawmill licensing, farm service forestry, fire protection on state and private forests, and administration of cooperative projects. As required by the Montana Constitution, the division reports to the State Board of Land Commissioners on matters relating to state lands.

(d) Conservation Districts Division . The conservation districts division supervises and coordinates the formation and operation of local grazing and soil and water conservation districts in the state. The division also develops and implements the state rangeland utilization plan, and processes applications for watershed projects.

(e) Oil and Gas Conservation Division (attached for administrative purposes only) . The oil and gas conservation division administers the oil and gas laws of the state. Its activities include classification of wells, well inspections and investigations, issuance of drilling permits, engineering studies, establishment of well spacing units and pooling orders, and core depository.

(3) Boards .

(a) Board of Oil and Gas Conservation . The board of oil and gas conservation is attached to the department for administrative purposes only. As such, the board is responsible for adopting rules and holding hearings under the oil and gas laws of the state, independent of the department.

(b) Board of Natural Resources and Conservation . Except for actions of the board of oil and gas conservation, the board must concur in actions of the department which grant or deny rights to the public. Consequently, the board must concur in rules adopted by the department, and in determinations or orders resulting from hearings held by the department. (For a more detailed explanation of the board's functions, inquiries may be directed to the director, who will inform the inquiring party as to where the guidelines can be found in the Administrative Rules of Montana.)

(4) Information or Submissions . General inquiries regarding the department may be addressed to the director. Specific inquiries regarding the functions of each division may be addressed to the administrator of that division. All requests for hearings, declaratory rulings, and for participation in rulemaking may be addressed to the director unless the notice in the Montana Administrative Register makes specific provisions for submissions.

(5) Personnel Roster . Addresses of the director and each division are as follows:

Director, Department of Natural Resources and Conservation,

Room 425, Mitchell Building, Helena, Montana 59620

Centralized Services Division, Room 432, Mitchell Building,

Helena, Montana 59620

Water Resources Division, Room 403, Mitchell Building, Helena, Montana 59620

Forestry Division, 2705 Spurgeon Road, Missoula, Montana 59801

Conservation Districts Division, Room 422, Mitchell Building, Helena, Montana 59620

Oil and Gas Conservation Division, 325 Fuller Avenue, Helena, Montana 59601

(6) Charts of Agency Organization and Function . Descriptive charts of the department of natural resources and conservation indicating the organization of the agency, the functions of each division, and which divisions are without rulemaking authority, are attached as the following four pages and are incorporated in this rule. (History: 2-4-202 , MCA; IMP , 2-4-202 , MCA; Eff. 12/31/72; AMD, 1977 MAR p. 1192, Eff. 12/24/77; AMD, 1979 MAR p. 1204, Eff. 10/12/79; AMD, Eff. 4/30/99.)

Sample form 3 : Petition from interested person.

BEFORE THE [agency]

OF THE STATE OF MONTANA

In the matter of the )

[adoption of a rule, ) PETITION

amendment of ARM [number] )

or repeal of ARM [number]] )

TO: All Concerned Persons

1. Petitioner's name and address is [name, address].

2. [Facts showing petitioner will be affected; for ex.: Petitioner is the owner of Sunset Rooming House, a three-story wood frame structure located at 222 11th Street, Anytown, Montana. Under ARM 1.6.604, petitioner is required to install a sprinkling system in petitioner's rooming house. The cost of a sprinkling system to petitioner would be $5,000.]

3. [Reasons for the proposed agency action; for ex.: Petitioner asserts a sprinkling system is not necessary in petitioner's case because the second and third floors of petitioner's rooming house each contain two fire exits leading to a fire escape. Petitioner contends that a heat-sensing fire alarm system would be an adequate alternative to protect the public safety in petitioner's rooming house.]

4. The rule as proposed to be [adopted, amended, repealed] would read as follows, stricken matter interlined, new matter underlined:

For ex.: Rule 1.6.604 SPRINKLER SYSTEMS - WHEN REQUIRED

(1) Except as otherwise provided in this rule , all wood frame structures of two or more stories used for public occupancy shall be equipped with a fire sprinkler system approved as to type and installation by the fire marshal bureau.

(2) Where a wood frame structure which is required by (1) of this rule to have a sprinkler system has two or more exit doors on each floor above the ground floor leading to an approved type of fire escape maintained for public use, a heat-sensing fire alarm system approved by the fire marshal bureau as to type and installation, may be substituted for a sprinkler system.

5. (Option 1:) [Petitioner has no knowledge of any person who may have a particular interest in the proposed agency action]; or

(Option 2:) [Persons known to petitioner to have an interest in the proposed agency action are: [name, address]].

6. (Option 1:) [Petitioner requests a [hearing or oral presentation] for expression of petitioner's and other interested persons' views]; or

(Option 2:) [Petitioner requests neither a hearing nor oral presentation of petitioner's views].

WHEREFORE, petitioner requests the [agency] to [type of proposed agency action].

[signature]

Petitioner

[date]

Sample form 4: Notice of public hearing on the proposed adoption, amendment and/or repeal of rules. Section 2-4-302, MCA. References to the proposed adoption, amendment and/or repeal are omitted if not applicable to your notice.

BEFORE THE [agency]

OF THE STATE OF MONTANA

In the matter of the adoption ) NOTICE OF PUBLIC

of a new rule [summary of ) HEARING ON THE PROPOSED

proposed rule]; the amendment ) [ADOPTION, AMENDMENT

of ARM [number]; and/or ) AND/OR REPEAL]

the repeal of ARM [number] )

TO: All Concerned Persons

1. On [date at least 20 days from publication of this notice] at [time] a public hearing will be held in room [number] of the [building] at [city], Montana, to consider the adoption of new Rule I, the amendment of ARM [number] and the repeal of ARM [number].

2. The [agency] will make reasonable accommodations for persons with disabilities who wish to participate in this public hearing or need an alternative accessible format of this notice. If you require an accommodation, contact [agency] no later than 5:00 p.m. on [date - no requirement specified in MAPA], to advise us of the nature of the accommodation that you need. Please contact [name; address; telephone; TTD number; FAX].

3. The proposed new rule provides as follows:

RULE I [catchphrase] [text of proposed rule].

AUTH: [statutory authority to adopt proposed rule]

IMP: [statute(s) implemented by rule]

(Include both AUTH: and IMP: after each proposed rule.)

(Option 1:) [Provide clear, thorough and easily understood statement of reasonable necessity which contains the principal reasons and rationale for the proposed rule]; or

(Option 2:) [provide clear, thorough and easily understood statement of reasonable necessity which contains the principal reasons and rationale for all proposed changes as indicated in paragraph number 5 below].

4. The rule proposed to be amended provides as follows, stricken matter interlined, new matter underlined:

[Number] [catchphrase] [text]

AUTH: [statutory authority to amend rule]

IMP: [statute(s) implemented by rule]

(When referring to an amendment, underline the MCA sections that constitute authority for the rule and are actually implemented by the amendment.)

(Option 1:) [Provide clear, thorough and easily understood statement of reasonable necessity which contains the principal reasons and rationale for the proposed rule]; or

5. (Option 2:) [Provide clear, thorough and easily understood statement of reasonable necessity which contains the principal reasons and rationale for proposed adoption and amendment and/or repeal; for ex.: Adoption of the new rule is necessary because investigations by the state fire marshal have indicated that at least six fatalities in three separate hotel or nursing home fires in recent years would probably have been prevented if sprinkler systems had been in the buildings. The amendment of ARM [number] is necessary because compliance with the present rule would be very expensive for the owners of several older buildings and the owners have presented credible evidence that the less expensive heat-sensing alarm systems would provide an equal measure of public safety].

6. ARM [number] which can be found on page [number] of the Administrative Rules of Montana, is proposed to be repealed because [rationale; for ex.: The department of health and environmental sciences has rules of similar import for hotels, boarding facilities, restaurants, nursing homes and health care facilities, and it appears that almost all wood frame structures of two or more floors used for public occupancy fall into one of these categories. ARM [number] is consistent with the health agency's rule or confusing to the public if inconsistent].

AUTH: [statutory authority to repeal rule]

IMP: [statute(s) implemented by rule]

7. Concerned persons may present their data, views or arguments, either orally or in writing, at the hearing. Written data, views or arguments may also be submitted to [name, address], and must be received no later than [date at least 28 days from publication of this notice, 2-4-302(4) , MCA].

8. [Name, address] has been designated to preside over and conduct the hearing.

9. The [agency] maintains a list of interested persons who wish to receive notices of rulemaking actions proposed by this agency. Persons who wish to have their name added to the list shall make a written request which includes the name and mailing address of the person to receive notices and specifies that the person wishes to receive notices regarding [subject matter options or combination thereof]. Such written request may be mailed or delivered to [name, address], faxed to the office at [number], or may be made by completing a request form at any rules hearing held by the [agency].

10. The bill sponsor notice requirements of 2-4-302, MCA (option 1:) [do not apply]; or (option 2:) [apply and have been fulfilled].

(must be signed by:)

By: [authorized person's signature]

[signer's name, title]

[agency]

[ rule reviewer's signature]

[signer's name, Rule Reviewer]

Certified to the Secretary of State [date]

Sample form 5 : Notice of proposed adoption of a substantive rule when no public hearing is contemplated. Sections 2-4-201, 2-4-302, MCA.

BEFORE THE [agency]

OF THE STATE OF MONTANA

In the matter of the ) NOTICE OF PROPOSED

adoption of a rule [summary; ) ADOPTION

for ex.: specifying the forms )

available for use under the ) NO PUBLIC HEARING

Montana Water Use Act] ) CONTEMPLATED

TO: All Concerned Persons

1. On [date at least 30 days from publication of this notice], the [agency] proposes to adopt a rule [summary; for ex.: specifying the forms available for use under the Montana Water Use Act].

2. The [agency] will make reasonable accommodations for persons with disabilities who wish to participate in the rulemaking process and need an alternative accessible format of this notice. If you require an accommodation, contact [agency] no later than 5:00 p.m. on [date - no requirement specified in MAPA], to advise us of the nature of the accommodation that you need. Please contact [name; address; telephone; TTD number; FAX].

3. The proposed rule provides as follows:

RULE I [catchphrase] [text of proposed rule].

AUTH: [statutory authority to adopt rule]

IMP: [statute(s) implemented by rule]

(Include AUTH: and IMP: after each proposed rule.)

(Option 1:) [Provide clear, thorough and easily understood statement of reasonable necessity which contains the principal reasons and rationale for the proposed rule]; or

4. (Option 2:) [Provide clear, thorough and easily understood statement of reasonable necessity which contains the principal reasons and rationale for proposed rule; for ex.: The rule is necessary to respond to a petition for its adoption filed by the Montana Water Users Association. The petition sets forth reasons why the forms should be available to the public. Copies of the petition are available from the department].

5. Concerned persons may submit their data, views or arguments concerning the proposed rule in writing to [name; address], to be received no later than [date at least 28 days from publication of this notice, 2-4-302(4) , MCA].

6. If persons who are directly affected by the proposed adoption wish to express their data, views and arguments orally or in writing at a public hearing, they must make written request for a hearing and submit this request along with any written comments they have to [name, address]. The comments must be received no later than [date at least 28 days from publication of this notice, 2-4-302(4) , MCA].

7. If the agency receives requests for a public hearing on the proposed adoption from either 10% or 25, whichever is less, of the persons who are directly affected by the proposed adoption; from the appropriate administrative rule review committee of the legislature; from a governmental subdivision or agency; or from an association having not less than 25 members who will be directly affected, a hearing will be held at a later date. Notice of the hearing will be published in the Montana Administrative Register. Ten percent of those persons directly affected has been determined to be [number] persons based on [for ex.: the 200 licensed plumbers in Montana].

8. The [agency] maintains a list of interested persons who wish to receive notices of rulemaking actions proposed by this agency. Persons who wish to have their name added to the list shall make a written request which includes the name and mailing address of the person to receive notices and specifies that the person wishes to receive notices regarding [subject matter options or combination thereof]. Such written request may be mailed or delivered to [name, address], faxed to the office at [number], or may be made by completing a request form at any rules hearing held by the [agency].

9. The bill sponsor notice requirements of 2-4-302, MCA (option 1:) [do not apply]; or (option 2:) [apply and have been fulfilled].

(must be signed by:)

By: [authorized person's signature]

[signer's name, title]

[agency]

[rule reviewer's signature]

[signer's name, Rule Reviewer]

Certified to the Secretary of State [date]

Sample form 6: Notice of proposed adoption of a procedural rule when no public hearing is contemplated. Sections 2-4-201, 2-4-302, MCA.

BEFORE THE [agency]

OF THE STATE OF MONTANA

In the matter of the ) NOTICE OF PROPOSED

adoption of procedural RULE I ) ADOPTION

[summary] )

) NO PUBLIC HEARING

) CONTEMPLATED

TO: All Concerned Persons

1. On [date at least 30 days from publication of this notice], the [agency] proposes to adopt new RULE I which [summary].

2. The [agency] will make reasonable accommodations for persons with disabilities who wish to participate in the rulemaking process and need an alternative accessible format of this notice. If you require an accommodation, contact [agency] no later than 5:00 p.m. on [no requirement specified in MAPA], to advise us of the nature of the accommodation that you need. Please contact [name; address; telephone; TTD number; FAX].

3. The proposed rule provides as follows:

RULE I [catchphrase] [text of proposed rule].

AUTH: [statutory authority to adopt rule]

IMP: [statute(s) implemented by rule]

(Include AUTH: and IMP: after each proposed rule.)

(Option 1:) [Provide clear, thorough and easily understood statement of reasonable necessity which contains the principal reasons and rationale for the proposed rule]; or

4. (Option 2:) [Provide clear, thorough and easily understood statement of reasonable necessity which contains the principal reasons and rationale for the proposed adoption].

5. Concerned persons may submit their data, views or arguments concerning the proposed adoption in writing to [name, address]. Any comments must be received no later than [date at least 28 days from publication of this notice, 2-4-302(4) , MCA].

6. The [agency] maintains a list of interested persons who wish to receive notices of rulemaking actions proposed by this agency. Persons who wish to have their name added to the list shall make a written request which includes the name and mailing address of the person to receive notices and specifies that the person wishes to receive notices regarding [subject matter options or combination thereof]. Such written request may be mailed or delivered to [name, address], faxed to the office at [number], or may be made by completing a request form at any rules hearing held by the [agency].

7. The bill sponsor notice requirements of 2-4-302, MCA (option 1:) [do not apply]; or (option 2:) [apply and have been fulfilled].

(must be signed by:)

By: [authorized person's signature]

[signer's name, title]

[agency]

[rule reviewer's signature]

[signer's name, Rule Reviewer]

Certified to the Secretary of State [date]

Sample form 7 : Notice of proposed amendment and/or repeal of a substantive rule when no public hearing is contemplated. Sections 2-4-201, 2-4-302, MCA. A notice of proposed adoption, amendment and repeal may be combined in one notice.

BEFORE THE [agency]

OF THE STATE OF MONTANA

In the matter of the ) NOTICE OF PROPOSED

amendment of ARM [number] ) AMENDMENT AND/OR REPEAL

summary], and/or the repeal )

of ARM [number] [summary] ) NO PUBLIC HEARING

) CONTEMPLATED

TO: All Concerned Persons

1. On [date at least 30 days from publication of this notice], the [agency] proposes to amend ARM [number] which [summary] and/or repeal ARM [number] which [summary].

3. The rule as proposed to be amended provides as follows, stricken matter interlined, new matter underlined:

[Number] [catchphrase] [text]

AUTH: [statutory authority to adopt rule]

IMP: [statute(s) implemented by rule]

(Include both AUTH: and IMP: after each proposed rule. When referring to an amendment underline the section(s) that constitute authority for the rule and the section(s) actually implemented by the amendment.)

(Option 1:) [Provide clear, thorough and easily understood statement of reasonable necessity which contains the principal reasons and rationale for the proposed action]; or

4. ARM [number], the rule proposed to be repealed, is on page [number] of the Administrative Rules of Montana.

AUTH: [statutory authority to repeal rule]

IMP: [statute(s) implemented by rule]

(Option 1:) [Provide clear, thorough and easily understood statement of reasonable necessity which contains the principal reasons and rationale for the proposed action]; or

5. (Option 2:) [Provide clear, thorough and easily understood statement of reasonable necessity which contains the principal reasons and rationale for the proposed actions]. ARM [number] is being amended because [rationale for the proposed amendment]. The repeal of ARM [number] is necessary because [rationale for proposed repeal].

6. Concerned persons may submit their data, views or arguments concerning the proposed [amendment and/or repeal] in writing to [name, address]. Any comments must be received no later than [date at least 28 days from publication of this notice, 2-4-302(4) , MCA].

7. If persons who are directly affected by the proposed [amendment and/or repeal] wish to express their data, views and arguments orally or in writing at a public hearing, they must make written request for a hearing and submit this request along with any written comments they have to [name, address]. A written request for hearing must be received no later than [date at least 28 days from publication of this notice, 2-4-302(4) , MCA].

8. If the agency receives requests for a public hearing on the proposed action(s) from either 10% or 25, whichever is less, of the persons who are directly affected by the proposed action(s) ; from the appropriate administrative rule review committee of the legislature; from a governmental subdivision or agency; or from an association having not less than 25 members who will be directly affected, a hearing will be held at a later date. Notice of the hearing will be published in the Montana Administrative Register. Ten percent of those persons directly affected has been determined to be [number] persons based on [for ex.: the 200 licensed plumbers in Montana].

10. The bill sponsor notice requirements of 2-4-302, MCA (option 1:) [do not apply]; or (option 2:) [apply and have been fulfilled].

(must be signed by:)

By: [authorized person's signature]

[signer's name, title]

[agency]

[rule reviewer's signature]

[signer's name, Rule Reviewer]

Certified to the Secretary of State [date]

Sample form 8 : Notice of proposed amendment and/or repeal of a procedural rule when no public hearing is contemplated. Use sample form 7 omitting paragraphs 7 and 8.

Sample form 9 : Repeal or amendment of a rule by direction of the legislature. Sections 2-4-302, 2-4-412, MCA.

BEFORE THE [agency]

OF THE STATE OF MONTANA

In the matter of the repeal ) NOTICE OF PROPOSED

or amendment of ARM [number] ) REPEAL OR AMENDMENT

[summary, for ex.: requiring )

sprinkler systems in wood )

frame structures of two or )

more stories used for public )

occupancy] )

TO: All Concerned Persons

1. On [date at least 30 days from publication of this notice], the [agency] will [repeal or amend] ARM [number], [summary; for ex.: requiring sprinkler systems in wood frame structures of two or more stories used for public occupancy].

3. The rule to be [repealed] is on page [number] of the Administrative Rules of Montana.

AUTH: [statutory authority to repeal rule]

IMP: [statute(s) implemented by rule]

4. The rule to be amended provides as follows, stricken matter interlined, new matter underlined:

[Number] [catchphrase] [text]

AUTH: [statutory authority to amend rule]

IMP: [statute(s) implemented by rule]

(When referring to an amendment, underline the MCA sections that constitute authority for the rule and are actually implemented by the amendment.)

(Option 1:) [Provide clear, thorough and easily understood statement of reasonable necessity which contains the principal reasons and rationale for the proposed repeal or change]; or

5. (Option 2:) [Provide clear, thorough and easily understood statement of reasonable necessity which contains the principal reasons and rationale for the proposed repeal or amendment; for ex.: The department is repealing this rule as directed by Senate Joint Resolution No. 10 of the 45th Legislature, the text of which sets forth the reasons for repealing the rule].

7. The bill sponsor notice requirements of 2-4-302, MCA (option 1:) [do not apply]; or (option 2:) [apply and have been fulfilled].

(must be signed by:)

By: [authorized person's signature]

[signer's name, title]

[agency]

[rule reviewer's signature]

[signer's name, Rule Reviewer]

Certified to the Secretary of State [date]

(See sample form 13 for notice of adoption.)

Sample form 10 : Notice of public hearing when no public hearing was originally contemplated. Section 2-4-302, MCA.

BEFORE THE [agency]

OF THE STATE OF MONTANA

In the matter of [same ) NOTICE OF PUBLIC HEARING

as original notice] )

TO: All Concerned Persons

1. On [date] the department published a notice at page [number] of the [year] Montana Administrative Register, Issue Number [number], of the proposed [adoption, amendment and/or repeal] of the above-captioned rule(s) . The notice of proposed agency action is amended as follows because [the appropriate administrative rule review committee, a government agency or subdivision, or the required number of persons designated therein] [has/have] requested a public hearing.

2. On [date], at [time], a public hearing will be held in room [number] of the [building] at [city], Montana, to consider the [adoption, amendment and/or repeal] of ARM [number], [summary; for ex.: requiring sprinkler systems in wood structures of two or more stories used for public occupancy].

3. The [agency] will make reasonable accommodations for persons with disabilities who wish to participate in this public hearing or need an alternative accessible format of this notice. If you require an accommodation, contact [agency] no later than 5:00 p.m. on [date - no requirement specified in MAPA], to advise us of the nature of the accommodation that you need. Please contact [name; address; telephone; TTD number; FAX].

4. Concerned persons may present their data, views or arguments, either orally or in writing, at the hearing. Written data, views or arguments may also be submitted to [name, address], and must be received no later than [date at least 28 days from publication of the original notice - longer is optional, 2-4-302(4) , MCA].

5. [Name, address] has been designated to preside over and conduct the hearing.

(must be signed by:)

By: [authorized person's signature]

[signer's name, title]

[agency]

[rule reviewer's signature]

[signer's name, Rule Reviewer]

Certified to the Secretary of State [date]

Sample form 11 : Amendment of notice of public hearing on proposed adoption, amendment and/or repeal of a substantive rule. Section 2-4-302, MCA.

BEFORE THE [agency]

OF THE STATE OF MONTANA

In the matter of [same as ) AMENDED NOTICE OF PUBLIC

original notice] ) HEARING ON PROPOSED

) ADOPTION, AMENDMENT AND/OR

) REPEAL

TO: All Concerned Persons

1. On [date] the department published notice at page [number] of the [year] Montana Administrative Register, Issue Number [number] of the proposed [adoption, amendment and/or repeal] of the above-captioned rules. The notice of proposed agency action is amended as follows because [reason for amending notice; for ex.: The time and place of hearing have been changed to [date] at [time], in room [number] of the [building], at [city], Montana].

3. Concerned persons may present their data, views or arguments, either orally or in writing, at the hearing. Written data, views or arguments may also be submitted to [name, address], and must be received no later than [date at least 28 days from publication of the original notice - longer is optional, 2-4-302(4) , MCA].

4. [Name, address] has been designated to preside over and conduct the hearing.

5. The [agency] maintains a list of interested persons who wish to receive notices of rulemaking actions proposed by this agency. Persons who wish to have their name added to the list shall make a written request which includes the name and mailing address of the person to receive notices and specifies that the person wishes to receive notices regarding [subject matter options or combination thereof]. Such written request may be mailed or delivered to [name, address], faxed to the office at [number], or may be made by completing a request form at any rules hearing held by the [agency].

(must be signed by:)

By: [authorized person's signature]

[signer's name, title]

[agency]

[rule reviewer's signature]

[signer's name, Rule Reviewer]

Certified to the Secretary of State [date]

Sample form 12: Corrected notice of adoption. Section 2‑4‑305(8), MCA.

BEFORE THE [agency]

OF THE STATE OF MONTANA

In the matter of [same as ) CORRECTED NOTICE

original notice] ) OF ADOPTION

TO: All Concerned Persons

1. On [date], the department published a notice at page [number] of the [year] Montana Administrative Register, Issue Number [number], of the adoption and amendment of the above‑captioned rules [for ex.: which are part of the ongoing process of seeking preauthorization from the Environmental Protection Agency under RCRA for the state of Montana to continue to operate an independent hazardous waste program].

2. The reason for the correction is [for ex.: The notice of amendment incorrectly showed a new definition for "component", when it should have shown an amendment of the existing definition of "component" and inadvertently omitted mention of definitions (109) through (124)]. The corrected rule amendment reads as follows:

16.44.202 DEFINITIONS In this chapter, the following terms shall have the meanings or interpretations shown below:

(1) through (14) remain the same.

(15)"Component" means any constituent part of a unit or any group of constituent parts of a unit which are assembled to perform a specific function (e.g., a pump seal, pump, kiln liner, kiln thermocouple). For the purposes of application to tanks or tank systems, "Ccomponent" means either the tank or ancillary equipment of a tank system.

(16) through (35) remain the same.

~~(37)~~ (36) same as proposed.

(36) through (124) remain the same but are renumbered (37) through (125).

AUTH: 75‑10‑405, MCA

IMP: 75‑10‑405, 75‑10‑406, MCA

3. Replacement pages for the corrected notice of adoption will be submitted to the Secretary of State on [date].

must be signed by:)

By: [authorized person's signature]

nbsp; [signer's name, title]

agency]

[rule reviewer's signature]

signer's name, Rule Reviewer]

Certified to the Secretary of State [date]

Sample form 13: Notice of adoption, amendment and/or repeal of a rule. Section 2-4-302, MCA.

BEFORE THE [agency]

OF THE STATE OF MONTANA

In the matter of [same as ) NOTICE OF [ACTION]

notice of proposed action] )

TO: All Concerned Persons

1. On [date], the [agency] published notice of the proposed adoption of new RULE I, amendment to ARM [number], and repeal of ARM [number] concerning [subject; for ex.: salons in residences] at page [number] of the [year] Montana Administrative Register, Issue Number [number].

2. (Option 1:) The agency has adopted new RULE I, ARM [permanent number; for ex.: 1.1.199] exactly as proposed; or

(Option 2:) The agency has adopted new RULE I, ARM [permanent number] with the following changes, stricken matter interlined, new matter underlined:

RULE I [permanent number] PAYMENT PROCEDURES

(1) Reimbursement principles are as follows:.

(a) and (b) same as proposed.

(d) and (e) same as proposed.

AUTH: [statutory authority to adopt rule]

IMP: [statute(s) implemented by rule]

3. (Option 1:) The agency has amended ARM [number] as proposed; or

(Option 2:) The agency has amended ARM [number] with the following changes, stricken matter interlined, new matter underlined:

[Number] [catchphrase] [text]

(Option 2 of paragraph 2.)

AUTH: [statutory authority to amend rule]

IMP: [statute(s) implemented by rule]

(When referring to an amendment, underline the section(s) that constitute authority for the amendment and the section(s) actually implemented by the amendment.)

4. The agency has repealed ARM [number] as proposed.

AUTH: [statutory authority to repeal rule]

IMP: [statute(s) implemented by rule]

5. (Option 1:) No comments or testimony were received; or (Option 2:) [When adverse comment or testimony has been received, the agency must acknowledge and accept or rebut the reasons given; for ex.: The following comments were received and appear with the [agency's] responses:

COMMENT 1: At the public hearing, a representative of the Montana Wood Contractors' Association opposed the rule on the grounds that it discriminated against wooden buildings arbitrarily. He argued that fire hazards are also significant in brick and stone buildings, and that the rule would divert new construction business to brick and stone contractors.

RESPONSE: The argument of the Wood Contractors is overruled. Statistics from the U.S. Fire Insurers' Association's 1974 Annual Report show that fires break out in wood frame buildings at an annual rate of 21.4 per thousand, and in all other types of buildings at a rate of 11.9 per thousand. This differential justifies a stricter rule for wooden buildings.

COMMENT 2: A written statement opposing the rule was received from John Doe of Anytown, Montana, who had just installed a heat-sensing fire alarm system in his three-story rooming house. He argued that such a system provided a margin of safety equal to that of a sprinkler system.

RESPONSE: The argument of Doe has merit on the assumption that adequate exits from upper floors are available. Accordingly, the rule has been modified to allow the substitution of a heat-sensing alarm system approved by the Fire Marshal for sprinkler systems in buildings having two or more exit doors leading to satisfactory fire escapes on each upper floor].

(must be signed by:)

By: [authorized person's signature]

[signer's name, title]

[agency]

[rule reviewer's signature]

[signer's name, Rule Reviewer]

Certified to the Secretary of State [date]

Sample form 14: Abbreviated notice for temporary emergency rulemaking. Section 2-4-303(1), MCA. (Temporary emergency amendments can be handled similarly.)

BEFORE THE [agency]

OF THE STATE OF MONTANA

In the matter of the adoption ) NOTICE OF ADOPTION OF

of a temporary emergency rule ) TEMPORARY EMERGENCY RULE

[summary; for ex.: on horse )

racing records] )

TO: All Concerned Persons

1. [Explanation of emergency; for ex.: The board has recently had cause to believe that a number of out-of-state horses will be brought to Montana to race in the forthcoming spring season meets, and that the out-of-state track records of some of these horses may not be fully disclosed. No rule of the board now requires such disclosure. The practice of running so-called "ringers" truly and clearly imperils public safety and welfare in that public dissatisfaction with race results and posted odds could lead to altercations and commotion in betting areas and stands. Such welfare and safety considerations are in imminent peril in that 14 meets are scheduled between this date and the publication of the July Administrative Register, the soonest that a remedial rule could be adopted under regular procedures. As these circumstances cannot be averted or remedied any other way, the board intends to adopt the following temporary emergency rule. The rule as adopted will be mailed to all licensed meets and commenting parties and published as an emergency rule in the next issue of the register.]

3. The temporary emergency rule will be effective [date].

4. The text of the temporary emergency rule is as follows:

RULE I [catchphrase] [text].

AUTH: [statutory authority to adopt rule]

IMP: [statute(s) implemented by rule]

(Include both AUTH: and IMP: for each temporary emergency rule proposed.)

5. The rationale for the temporary emergency rule is as set forth in paragraph 1.

6. A standard rulemaking procedure will be undertaken prior to the expiration of this temporary emergency rule.

7. Concerned persons are encouraged to submit their comments during the upcoming standard rulemaking process. If concerned persons wish to be personally notified of that rulemaking process, they should submit their names and addresses to [name, address].

9. The [name of the appropriate administrative rule review committee] has been notified of the adoption of this temporary emergency rule.

10. The bill sponsor notice requirements of 2-4-302, MCA [(option 1:) do not apply; or (option 2:) apply and have been fulfilled].

(must be signed by:)

By: [authorized person's signature]

[signer's name, title]

[agency]

[rule reviewer's signature]

[signer's name, Rule Reviewer]

Certified to the Secretary of State [date]

Sample form 15: Notice of proposed adoption of temporary rules. Section 2-4-303(2), MCA. (Temporary amendments to rules can be handled similarly. See also sample form 7.)

BEFORE THE [agency]

OF THE STATE OF MONTANA

In the matter of the ) NOTICE OF PROPOSED ADOPTION

adoption of temporary rules ) OF TEMPORARY RULES

on [subject] )

) NO PUBLIC HEARING

) CONTEMPLATED

TO: All Concerned Persons

1. On [date at least 30 days after publication of this notice] the [agency] proposes to adopt temporary rules on [subject], adopted pursuant to 2-4-303(2), MCA. On [date], H.B. or S.B. [number], becomes effective. [Describe what act does and why temporary rules are necessary; for ex.: That act generally revises the public gambling laws of Montana. Among other things, the act: (1) legalizes sports tab games; (2) substantially changes the statutes governing sports pools; and (3) establishes a license application processing fee. The department finds it necessary to adopt temporary rules in these three areas in order to implement the statute as closely as possible to its effective date.]

3. The temporary rule will be effective until October 1, [year of adoption].

4. The proposed temporary rules provide as follows:

RULE I [catchphrase] [text]

AUTH: [statutory authority to adopt rule]

IMP: [statute(s) implemented by rule]

(Include both AUTH: and IMP: for each temporary rule proposed.)

5. The rationale for the temporary rule is set forth in paragraph 1.

6. Concerned persons are invited to submit their data, views or arguments concerning the proposed rules in writing to [name, address]. Comments must be received no later than [at least 28 days after publication of this notice]. A standard rulemaking proceeding with full public participation will be initiated for the final rules which will include and replace these temporary rules.

7. If persons who are directly affected by the proposed adoption wish to express their data, views and arguments orally or in writing at a public hearing, they must make written request for a hearing and submit this request along with any written comments they have to [name, address]. Requests must be received no later than [date at least 28 days from publication of this notice].

8. If the agency receives requests for a public hearing on the proposed adoption from either 10% or 25, whichever is less, of the persons who are directly affected by the proposed adoption; from the appropriate administrative rule review committee of the legislature; from a governmental subdivision or agency; or from an association having not less than 25 members who will be directly affected, a hearing will be held at a later date. Notice of the hearing will be published in the Montana Administrative Register. Ten percent of those persons directly affected has been determined to be [number] persons, based on [for ex.: the number of licensees affected].

10. The bill sponsor notice requirements of 2-4-302, MCA [(option 1:) do not apply; or (option 2:) apply and have been fulfilled].

(must be signed by:)

By: [authorized person's signature]

[signer's name, title]

[agency]

[rule reviewer's signature]

[signer's name, Rule Reviewer]

Certified to the Secretary of State [date]

Sample form 16: Notice of adoption of temporary rules.

BEFORE THE [agency]

OF THE STATE OF MONTANA

In the matter of the ) NOTICE OF ADOPTION OF

adoption of temporary rules ) TEMPORARY RULES

on [subject] )

TO: All Concerned Persons

1. On [date], the [agency] published notice of the proposed adoption of temporary rules pertaining to [subject] at [page] of the [year] Montana Administrative Register, Issue Number [number].

2. The department adopts temporary RULE I exactly as proposed.

3. The department adopts temporary RULE II with the following changes:

For ex.: RULE II (No ARM number is assigned to temporary rules.) DEFINITIONS As used throughout this subchapter, the following definitions apply:

(1) through (7) same as proposed.

(8) "Manufacturer of gambling devices not legal in Montana" means a person who:

(a) assembles a completed or uncompleted piece of equipment intended for use as a gambling device which is not specifically authorized in Montana but is lawful in another jurisdiction; or

(b) manufactures sports tab cards for sale in Montana to be used in conducting a sports tab game. For the purposes of this subsection, the manufacturer need not be located in Montana.

(9) and (10) same as proposed.

AUTH: 23-5-115, MCA

IMP: 23-5-112, MCA

4. The following comments were received and appear with the [agency's] responses:

COMMENT 1: Senate Bill 427, effective July 1, 1991, expands the definition of a "manufacturer of gambling devices not legal in Montana" to include manufacturers of sports tab cards. RULE II should be amended to include the expanded definition.

RESPONSE: The Department incorporated this suggestion in RULE II.

5. This temporary action is effective [date].

(must be signed by:)

By: [authorized person's signature]

[signer's name, title]

[agency]

[rule reviewer's signature]

[signer's name, Rule Reviewer]

Certified to the Secretary of State [date]

Sample form 17: Notice of proposed adoption of amendment to a model code, federal agency rule or similar publication now incorporated by reference. Section 2-4-307, MCA.

BEFORE THE [agency]

OF THE STATE OF MONTANA

In the matter of the adoption ) NOTICE OF PROPOSED ADOPTION

of an amendment to a [model )

code, federal agency rule or ) NO PUBLIC HEARING

similar publication] presently ) CONTEMPLATED

incorporated by reference in )

ARM [number] )

TO: All Concerned Persons

1. The [agency] hereby gives notice of the adoption and incorporation by reference of a later amendment to [citation to latest version of publication, including date]. [Citation to publication] is presently incorporated by reference in ARM [number, catchphrase].

2. ARM [number] is proposed to be amended as follows, stricken matter interlined, new matter underlined:

For ex.: 23.7.301 ADOPTION OF UNIFORM FIRE CODE (1) The fire prevention and investigation ~~bureau~~ program hereby adopts and incorporates by reference the Uniform Fire Code and appendices, ~~1994~~ 1995 edition (UFC), and the Uniform Fire Code Standards, ~~1994~~ 1995 edition (UFC Standards), with the additions, amendments and deletions enumerated in this subchapter. Copies of the ~~Uniform Fire Code~~ UFC and related materials may be obtained from the International Conference of Building Officials, 5360 South Workman Mill Road, Whittier, CA 90601-2298, ~~(310) 692-4226~~ 1-800-423-6587, or from the MSU Fire Training School, 2100 16th Avenue South, Great Falls, MT 59405-4997, (406) ~~761-7885~~ 771-4336.

AUTH: 50-3-102, MCA

IMP: 50-3-103, MCA

The Department of Justice wishes to enforce the updated safety provisions found in the 1995 Uniform Fire Code. In order to do so, the department must, pursuant to 2-4-307, MCA, officially adopt that version of the Uniform Fire Code.

3. The [agency] will make reasonable accommodations for persons with disabilities who wish to participate in the rulemaking process and need an alternative accessible format of this notice. If you require an accommodation, contact [agency] no later than 5:00 p.m. on [date - no requirement specified in MAPA], to advise us of the nature of the accommodation that you need. Please contact [name, address; telephone; TTD number; FAX].

4. The effective date for the adoption of the later amendment is [date - effective date may be no sooner than 30 days after the date upon which the final notice of adoption is published unless the 30 days causes a delay that jeopardizes compliance with federal law or qualification for federal funding in which event the effective date may be no sooner than the date of publication, 2-4-307(5), MCA].

5. If the agency receives requests for a public hearing on the proposed action from either 10% or 25, whichever is less, of the persons who are directly affected by the proposed action; from the appropriate administrative rule review committee of the legislature; from a governmental subdivision or agency; or from an association having not less than 25 members who will be directly affected, a hearing will be held at a later date. Notice of the hearing will be published in the Montana Administrative Register. Ten percent of those persons directly affected has been determined to be [number] persons based on [for ex.: the number of licensees affected].

(must be signed by:)

By: [authorized person's signature]

[signer's name, title]

[name of agency]

[rule reviewer's signature]

[signer's name, Rule Reviewer]

Certified to the Secretary of State [date]

(See sample form 13 for notice of adoption.)

Sample form 18: Notice of contested case hearing.

BEFORE THE [agency]

OF THE STATE OF MONTANA

In the matter of [summary; )

for ex.: the Insurance ) NOTICE OF HEARING ON

Producer's License of ) REVOCATION OF LICENSE

John Doe] )

TO: [name of party]

At [time], [date], at [address], a hearing will be held for the [subject; for ex.: revocation of the insurance producer's license of John Doe].

The [agency] will make reasonable accommodations for persons with disabilities who wish to participate in this hearing or need an alternative accessible format of this notice. If you require an accommodation, contact [agency] no later than 5:00 p.m. on [date - no requirement specified in MAPA], to advise us of the nature of the accommodation that you need. Please contact [name, address; telephone; TTD number; FAX].

This hearing is held under the authority of [MCA section or agency regulation]. Violation of [MCA section or agency regulation] is alleged in that [statement of facts constituting alleged violation; for ex.: (Option 1:) [Name] misappropriated to his own use money belonging to a policyholder, specifically the sum of $500 from Mary Smith on or about the 1st day of March, 1973; or

(Option 2:) [Name] misappropriated to his own use money belonging to a policyholder. A more definite and detailed statement of the allegation may be obtained by applying to [name, address]].

You are entitled to attend this hearing and respond and present evidence and arguments on all issues involved in this action.

You have a right to be represented by counsel at the hearing. If you desire to contest the proposed agency action, or to waive formal proceedings pursuant to 2-4-603, MCA, you must notify [name, address] in writing within [number of days which provides reasonable opportunity to prepare] days of service of this notice on you. Failure to notify [name] will result in [proposed agency action; for ex.: revocation] on the date of this hearing.

Dated: [date]

(must be signed by:)

By: [authorized person's signature]

Sample form 19: Notice of immediate suspension or revocation of a license.

BEFORE THE [agency]

OF THE STATE OF MONTANA

In the matter of [type of ) NOTICE OF [action taken;

license and name of holder; ) for ex.: SUSPENSION OF

for ex.: Insurance Producer's ) PRODUCER'S LICENSE] AND

License of John Doe] ) OF HEARING FOR [SUSPENSION

) OR REVOCATION] OF [TYPE

) OF LICENSE]

TO: [Name of license holder]

At [time], [date], at [room, building, address], a hearing will be held for the [suspension or revocation] of the [type of license] of [name of license holder].

This hearing is held under the authority of [number], MCA. Violation of [MCA section or agency regulation] is alleged.

Pending the hearing, the [type of license] of [name of license holder] is [suspended or revoked] as of the date of this notice. This [suspension or revocation] is based on; for ex.: [(Option 1:) misappropriation to his own use of money belonging to a policyholder, specifically $500 from Mary Smith, on or about the 1st day of March, 1973; or

(Option 2:) misappropriation to his own use of money belonging to a policyholder. A more definite and detailed statement of the allegation may be obtained by applying to [name, address].

The [agency] finds that the public welfare imperatively requires emergency action, in that [finding of fact; for ex.: John Doe has notified the commissioner that he intends to continue the practice of retaining for his own use initial payments received by him from his clients].

You are entitled to attend the hearing and present evidence and arguments on whether the [suspension or revocation] should be made permanent. You have a right to be represented by counsel at the hearing. If you wish to contest [suspension or revocation], or if you desire to waive formal proceedings under 2-4-603, MCA, you must notify [name, address] in writing within [number of days which provides a reasonable opportunity to prepare] days of service of this notice on you. Failure to notify [name] of your contest of this action will result in [suspension or revocation] on the date of this hearing.

Dated: [date]

(must be signed by:)

By: [authorized person's signature]

Sample form 20: Default order.

BEFORE THE [agency]

OF THE STATE OF MONTANA

In the matter of [summary; )

for ex.: Insurance Producer's ) DEFAULT ORDER

License of John Doe] )

On [date], a Notice of Proposed [agency action, for ex.: Revocation of Agent's License] was served on [name; address], by the sheriff of [county], Montana. A copy of the sheriff's return is attached to this order and marked Exhibit "A". A copy of the notice is attached to this order and marked Exhibit "B".

The notice provided an opportunity for hearing if requested within [number] days. More than [number] days have elapsed since service of the order and no request for hearing has been received. The [agency official] considered the evidence and exhibits and makes the following determinations:

FINDINGS OF FACT

[For ex.: On the first day of March, 1973, John Doe appropriated to his own use money belonging to a policyholder, specifically $500 from Mary Smith, as is indicated by sworn statements by two witnesses, Mary Jones and Robert Jones, both being competent to testify and having personal knowledge of the transaction under consideration.]

CONCLUSIONS OF LAW

[For ex.: Section 33-17-1001(1), MCA, provides that the commissioner may revoke an insurance producer's license if he finds that the licensee has misappropriated or converted to his own use money belonging to policyholders. The commissioner has so found; thus cause exists under 33-17-1001(1)(d), MCA, for the revocation of the insurance producer's license of John Doe.]

ORDER

[For ex.: The insurance producer's license of John Doe is revoked effective August 1, 1992.]

Dated: [date]

(must be signed by:)

By: [authorized person's signature]

Sample form 21: Order appointing a hearing examiner.

BEFORE THE [agency]

OF THE STATE OF MONTANA

In the matter of the [same as ) APPOINTMENT OF HEARING

original notice] ) EXAMINER

TO: All Interested Persons

On [date], a notice of hearing for [for ex.: revocation of insurance producer's license] was served on [name]. On [date], the agency received written notice that [name] will appear at the hearing to contest the intended agency action. [Name] is appointed the hearing examiner in the above action. All correspondence and motions in the above matter should be directed to the hearing examiner at [address].

The [agency] will make reasonable accommodations for persons with disabilities who wish to participate in this process and need an alternative accessible format of this notice. If you require an accommodation, contact [agency] no later than 5:00 p.m. on [date - no requirement specified in MAPA], to advise us of the nature of the accommodation that you need. Please contact [name, address; telephone; TTD number; FAX].

Dated: [date]

(must be signed by:)

By: [authorized person's signature]

Sample form 22: Final order.

BEFORE THE INSURANCE COMMISSIONER

OF THE STATE OF MONTANA

In the matter of the ) FINDINGS OF FACT,

Insurance Producer's ) CONCLUSION OF LAW, ORDER

License of John Doe ) AND NOTICE OF

) OPPORTUNITY

) FOR JUDICIAL REVIEW

After notice and hearing on the proposed revocation of the insurance producer's license of John Doe, for appropriation of policyholder's money, the insurance commissioner considered the evidence and exhibits and makes the following disposition of this contested case.

PROPOSED FINDINGS OF FACT

Counsel for John Doe proposed that the commissioner find that: The personal check of Mary Smith was deposited to a trust account maintained by agent Doe. The commissioner does not accept this proposed finding of fact because it was contradicted by two witnesses, both maintaining that the bank account was used for personal purposes by John Doe.

FINDINGS OF FACT

The licensee, John Doe, received the personal check of Mary Smith in the amount of $500 on the 1st day of March 1992. The licensee, John Doe maintained two checking accounts, one designated John Doe Insurance, Trust Account, the other a joint checking account between John Doe and Jane Doe. The joint checking account had a mailing address which was 100 Main Street, Anytown, Montana. 100 Main Street is the residence of John and Jane Doe. Thereafter, over a period of two weeks John and Jane Doe drew checks for rent, cash and groceries against the $500 deposited. On March 1, 1992, John Doe gave to Mary Smith a receipt which read:

Received of Mary Smith the sum of $500 in payment of initial premium of life insurance policy to be issued by the Sandy Bottom Life Insurance Company of North Dakota in the amount of $150,000 insuring the life of Mary Smith.

/s/ John Doe, Producer

Sandy Bottom Life Insurance

Company of North Dakota

The commissioner finds that John Doe appropriated to his own use money belonging to a policyholder.

CONCLUSIONS OF LAW

Section 33-17-1001(1)(2), MCA, provides that the commissioner may revoke an insurance producer's license if he finds that the licensee has misappropriated or converted to his own use money belonging to policyholders. The commissioner has so found; thus cause exists under 33-17-1001(1)(d), MCA, for the revocation of the insurance producer's license of John Doe.

ORDER

The insurance producer's license of John Doe is revoked effective August 1, 1992.

Dated: [date]

(must be signed by:)

By: [authorized person's signature

NOTICE: You are entitled to judicial review of this Order in accordance with 2-4-702, MCA. Judicial review may be obtained by filing a petition in district court within thirty days after the service of this Order.

Sample form 23: Petition for declaratory ruling.

BEFORE THE [agency]

OF THE STATE OF MONTANA

In the matter of [summary; )

for ex.: Application )

of John Doe, an insurance ) PETITION FOR

producer, for a declaratory ) DECLARATORY

ruling on the applicability ) RULING

of 33-17-1001(1)(d), MCA, )

to his trust account) )

1. Petitioner's name and address is [name, address].

2. [Facts, for ex.: Petitioner maintains an insurance office in his residence in Anytown, Montana. As part of his business petitioner maintains a trust account and a joint checking account under one number. Petitioner regularly deposits checks received from clients into the checking account for future transmittal to petitioner's employer, Sandy Bottom Insurance Company of North Dakota. The insurance commissioner has threatened to bring proceedings under 33-17-1001(1)(d), MCA, for revocation of petitioner's license.]

3. The [statute, regulation, order] as to which petitioner requests a declaratory ruling is [number] which provides that [pertinent provisions].

4. The question presented for declaratory ruling by the agency is [for ex.: whether the above statute makes the producer's license subject to revocation for maintaining a combination trust account and private account].

5. Petitioner contends that [for ex.: his activity is not an illegal withholding, because he does not use any of the deposited money in trust for his own use].

6. Petitioner requests a declaratory rule that [for ex.: he maintains one checking account for both trust and private moneys without violation of 33-17-1001(1)(d), MCA].

7. (Option 1:) Petitioner knows of no other party similarly affected; or

(Option 2:) Petitioner knows of the following parties who are similarly affected: _______________.

Dated: [date]

________________________________

[name]

History: 2-4-202 , MCA; IMP , 2-4-202 , MCA; Eff. 12/31/72; AMD, 1977 MAR p. 1192, Eff. 12/24/77; AMD, 1979 MAR p. 1238, Eff. 10/12/79.