Nebraska Administrative Code
Topic - EDUCATION, DEPARTMENT OF
Title 92 - NEBRASKA DEPARTMENT OF EDUCATION
Chapter 64 - PROCEDURES FOR NEGOTIATED RULEMAKING
Attachment 92-64-4
Current through March 20, 2024
BEFORE THE STATE DEPARTMENT OF EDUCATION STATE OF NEBRASKA
In the matter of the Negotiated ) Certification of
Rulemaking Committee for ) Financial
[Insert name of the proposed ) Need
Negotiated Rulemaking Committee], )
____ NAC ____.
STATE OF NEBRASKA )
) ss.
COUNTY OF _________ )
COMES NOW the undersigned, being first duly sworn, and hereby states and certifies as follows:
1. I am a member of the above-referenced negotiated rulemaking committee created by the State Department of Education.
2. In connection with my duties on that committee, I represent [insert the name of the appropriate identified interest].
3. In connection with my duties on that committee, I have incurred or will incur expenses and/or other costs.
4. I certify that I have a lack of adequate financial resources to serve on the above- referenced negotiated rulemaking committee, and that I need financial assistance from the Department in order to serve.
_________________________________________________________
Signature of Affiant
Subscribed and sworn to before me this ______ day of ___________, 19 ______ .
________________________________
Notary Public
