Denial Notice and Notification of Rights, SFN 741 660-05-65-35

(Revised 1/1/08 ML 3118)

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To deny an application for a license, SFN 741 must be completed and sent to the applicant along with the documents listed below. Contact the Program Administrator of Adult Family Foster Care, Division, for guidance prior to initiating this action.

1. The regional Human Service Center shall notify the applicant of the intent to deny an application by certified mail, return requested.
2. A copy of the statutes and Department rules authorizing denial must be given to the applicant.
3. Specific reasons for denial must be cited in writing. (List each reason under "Notice of Intent to Deny the Applicant for a License to Provide Adult Family Foster Care.") A copy of applicable statutes and Department rules must be given to the applicant.
4. The applicant must be given notice in writing of their rights. The "Notification of Rights" section addresses all requirements of the law (N.D.C.C. Section 50-11-08) regarding the applicant's rights.

A copy of the completed form must be sent to the Division.

This form has attached carbon copies. Copies of this form can be obtained from Division by contacting the AFFC Program Administrator.