Link to State of North Dakota

 

Cover Letter for Provisional License (Sample Form) 660-05-65-60

(Revised 1/1/08 ML 3118)

View Archives

 

 

The Human Service Center, following consultation with the AFFC Program Administrator, may issue a provisional license for up to six months for an initial applicant or renewal of a license.  A copy of the provisional license must be sent to the County Social Service Agency and the Division.

 

This form may be duplicated.

 

 

 

 

 

 

 

 

 

 

 

Return to DHS Policy Manuals Homepage

[Disclaimer]

Get Adobe Reader