Nebraska Administrative Code
Topic - ATTORNEY GENERAL
Title 53 - MODEL RULES OF AGENCY PROCEDURE
Chapter 3 - Model Regulations and Procedures Governing Agency Declaratory Orders
Appendix A

BEFORE THE [AGENCY NAME], STATE OF NEBRASKA

In the matter of )

the application of [name] ) PETITION FOR

) DECLARATORY ORDER

)

1. Petitioner's name and address;

2. The name and address of all persons who or entities which may have a specific interest in the applicability of the statute, rule, regulation, or order, or who may be adversely affected by the issue sought to be resolved;

3. All material facts and specific circumstances;

4. All rules of law which apply;

5. Petitioner's demand for relief;

DATED on this __ day of ____, 199_ .