New Hampshire Code of Administrative Rules
Plc - Executive Director, Office of Professional Licensure and Certification
Chapter Plc 1000 - FEES, PER DIEMS, AND REIMBURSABLE EXPENSES
Part Plc 1003 - PER DIEM COMPENSATION; REIMBURSABLE EXPENSES
Section Plc 1003.06 - Requests for Reimbursable Travel Expenses
Current through Register No. 13, March 27, 2025
(a) Any member who
wishes to receive reimbursement for mileage, parking, or tolls, or any
combination thereof, shall submit the information listed in (e), below, to the
director of the division of licensing and board administration using state of
New Hampshire Form A-4M "STATE OF NEW HAMPSHIRE PAYMENT VOUCHER IN-STATE
REIMBURSEMENT REQUEST", available by going to
(b) No member shall submit a request more frequently than once in any calendar month.
(c) Each request shall be signed by the member submitting the request, which shall constitute the member's attestation that:
(d) The submission of false, incomplete, or misleading information shall constitute grounds for the director to deny the request and to seek reimbursement of any amounts paid based on the request.
(e) The information required to be submitted shall be as follows:
(f) A member submitting a request for travel expense reimbursement for board-related business shall submit a copy of the signed authorization received pursuant to Plc 1003.08 with the request.