§1480.130. License Extension upon the Death of a Person Licensed Individually

a)         An immediate family member shall submit written notice on a form containing the information prescribed by the Commission or in a form of the letter to the Commission.  Incomplete or incorrect written notices shall be refused or rejected by the Commission.  If the immediate family member submits the written notice in the form of a letter, the letter shall provide, at minimum, the following information:

 

1)         Full legal name of the deceased license holder;

 

2)         Identifying number of the license;

 

3)         Full legal name of the immediate family member;

 

4)         Address of the immediate family member;

 

5)         Telephone number of the immediate family member;

 

6)         Relationship of the immediate family member to the license holder;

 

7)         Date of death of the license holder;

 

8)         Brief statement requesting a license extension; and

 

9)         Notarized signature of the immediate family member.

 

b)         An immediate family member shall submit, along with the written notice, the death certificate of the deceased license holder and:

 

1)         If the immediate family member is a child or a parent of the deceased license holder, the immediate family member's birth or adoption certificate; or

 

2)         If the immediate family member is a sibling of the deceased license holder, the immediate family member's birth or adoption certificate; or

 

3)         If the immediate family member is a spouse of the deceased license holder, a marriage or civil union certificate issued to the deceased license holder and surviving spouse.