Architect License Reinstatement & Administrative Hearing Request

ARCHITECT LICENSE REINSTATEMENT & ADMINISTRATIVE HEARING REQUEST

Before you use this: Select Part A or Part B, identify the actual board and order or notice, and check the current state rules for the deadline, required form, filing method, service, and any hearing or reinstatement prerequisites. File the board's required form with this statement if the board allows an attachment.

Part A — Request for administrative hearing

[__/__/____]

[BOARD OR AGENCY NAME]

[APPROVED FILING ADDRESS OR PORTAL]

Re: Request for hearing; [CASE OR NOTICE NUMBER]

Respondent: [ARCHITECT FULL LEGAL NAME]

Registration number and status: [NUMBER AND STATUS]

Notice received: [__/__/____]

To [BOARD OR HEARING OFFICER]:

I received the [EXACT TITLE OF NOTICE] dated [__/__/____] in the above matter. I request a hearing regarding [IDENTIFY PROPOSED ACTION OR CHARGES] under [GOVERNING RULE OR NOTICE PROVISION, IF VERIFIED]. Please treat this as my response to that notice to the extent the applicable procedure permits.

My response to the stated grounds is:

The architectural project, registration, or continuing-education records relevant to this matter are [IDENTIFY CONTRACTS, PLANS, PERMITS, INSPECTIONS, NCARB RECORD, HSW OR OTHER EDUCATION RECORDS AS APPLICABLE]. The chronology is [DATES AND EVENTS]. I request [SPECIFIC DISPOSITION: WITHDRAWAL, MODIFICATION, HEARING, OR OTHER RELIEF AVAILABLE UNDER THE NOTICE] because [FACTS AND VERIFIED AUTHORITY].

Please send hearing and case communications to [MAILING ADDRESS, EMAIL, PHONE] and, if represented, to [COUNSEL NAME AND ADDRESS]. I ask for confirmation that this request was received.

Respectfully submitted,

Signature: [________________________________]

Printed name: [________________________________]

Date signed: [__/__/____]

Exhibits enclosed: [LIST OR "NONE"]

Delivery record: Sent to [RECIPIENT] by [APPROVED METHOD] on [__/__/____]; confirmation number [NUMBER OR "NONE"].

Part B — Petition for reinstatement

[__/__/____]

[BOARD OR AGENCY NAME]

[APPROVED FILING ADDRESS OR PORTAL]

Re: Petition to reinstate architectural registration [NUMBER]; [ORDER OR CASE NUMBER]

To [BOARD OR HEARING OFFICER]:

I, [FULL LEGAL NAME], request reinstatement of my architectural registration, [NUMBER], which [EXPIRED / WAS SUSPENDED / WAS REVOKED / WAS SURRENDERED] on [__/__/____] under [ORDER OR EVENT]. I submit this petition under [CURRENT BOARD RULE OR ORDER PROVISION, IF VERIFIED].

The order or rule states these conditions for my application: [IDENTIFY EXACT CONDITIONS AND DATES]. My actions to meet them are:

My present architectural practice qualifications include [EDUCATION, EXAMINATION, CONTINUING EDUCATION, HSW COURSEWORK, PRACTICE SUPERVISION, OR OTHER CURRENT FACTS]. I have addressed the conduct or deficiency identified in the order by [SPECIFIC ACTIONS WITH DATES]. My current registration and discipline status in other jurisdictions is [ACCURATE STATUS].

I request that the board [REINSTATE THE REGISTRATION / SET A HEARING / IDENTIFY ADDITIONAL REQUIRED MATERIAL], subject to the governing rule and order. Please send the decision and any scheduling notice to [MAILING ADDRESS, EMAIL, PHONE].

Respectfully submitted,

Signature: [________________________________]

Printed name: [________________________________]

Date signed: [__/__/____]

Exhibits enclosed: [ORDER, EDUCATION RECORD, COMPLETION PROOF, RECOMMENDATIONS, OR OTHER DOCUMENTS ACTUALLY ENCLOSED].

Delivery record: Sent to [RECIPIENT] by [APPROVED METHOD] on [__/__/____]; confirmation number [NUMBER OR "NONE"].