New Hampshire Code of Administrative Rules
Ch - Board of Chiropractic Examiners
Chapter Ch 400 - CONTINUED STATUS
Part Ch 402 - RENEWAL OF LICENSE
Section Ch 402.07 - Effect of the Renewal Applicant's Signature

(a) States that he or she is applying for a renewal of a license to practice chiropractic;

(b) Certifies that he or she is the individual identified in the renewal application.

(c) Promises that he or she will notify the board in writing within 30 days of any change in the information provided in the renewal application, even after the application has been granted and the license renewed;

(d) Consents to the board's use for all purposes of the mailing and electronic addresses provided to the board in the renewal application or thereafter;

(e) Certifies that the information provided on the renewal application form and the documentation provided to support the renewal application are, to the best of the applicant's knowledge and belief, true, accurate, complete and unaltered;

(f) Acknowledges that, pursuant to RSA 641:3, I, the knowing making of a false statement on the renewal application form is punishable as a misdemeanor, and that, if he or she knowingly provides the board with any false, inaccurate, incomplete or altered information or documentation, the board has the authority to deny the renewal application or, after a hearing, to take disciplinary action against the renewed license; and

(g) Certifies that he or she has read and understands RSA 316-A and the current administrative rules of the New Hampshire Board of Chiropractic Examiners.