R9-9B-301. Application for a Funeral Establishment License or Interim Funeral Establishment Permit

A. A person may not advertise or operate for compensation a funeral establishment in this state unless the person is licensed by the Department or has an interim permit issued according to this Article. B. An applicant for a funeral establishment license shall submit to the Department an application that contains: 1. The following, according to A.R.S. § 32-1383, in a Department-provided format: a. The applicant’s name, mailing address, email address, and telephone number; b. The name or proposed name of the funeral establishment, including the: i. Physical address; ii. Mailing address, if different from the physical address; iii. Telephone number; iv. Email address; v. Tax ID number; and vi. If applicable, the applicant’s Arizona Corporation Commission entity file number; c. Whether the applicant is a business organization and, if so: i. The type of business organization; ii. The name and address of the Arizona statutory agent, or agent appointed to receive process; iii. The name, title, telephone number, email address, and address of the individual the Department may contact about the application or operation of the funeral establishment; and iv. The name and address of each person owning 10 percent or more of the business organization; d. Whether the applicant is requesting the issuance of an interim permit and, if so: i. The name of the previous licensee of the funeral establishment; ii. The license number previously issued for the funeral establishment; iii. The name of the funeral establishment listed on the license in subsection (B)(1)(d)(ii), if different from the name in subsection (B)(1)(b); and iv. The date of the change of ownership of the funeral establishment; e. Whether the applicant or any individual listed according to subsection (B)(1)(c)(iv) has, in any jurisdiction: i. Had a funeral establishment license or certificate denied, suspended, or revoked, or had disciplinary action taken against the funeral establishment license or certificate; or ii. Voluntarily surrendered a funeral establishment license or certificate in lieu of disciplinary action; f. Whether the applicant or any individual listed according to subsection (B)(1)(c)(iv) has ever been convicted of or entered into a plea of no contest to a felony or a misdemeanor in this or another state and, if so: i. The date of the conviction, ii. The state or jurisdiction of the conviction, iii. An explanation of the crime of which the applicant was convicted or entered into a plea of no contest to, and iv. The disposition of the case; g. The name and license number of the responsible funeral director; h. Whether the funeral establishment embalms or will embalm on-site and, if not, the name, address, and license number of another funeral establishment embalming on behalf of the funeral establishment; i. Whether the funeral establishment is ready for a licensing inspection by the Department; j. If the funeral establishment is not ready for a licensing inspection, as specified in subsection (B)(1)(i), the date the facility will be ready for a licensing inspection; k. Whether the funeral establishment complies with local zoning ordinances, building codes, and fire codes; l. Whether the applicant agrees to allow the Department to submit supplemental requests for information under R9-9B-102(C)(3); m. An attestation that the information and documentation submitted as part of the application for a funeral establishment license are true and accurate; and n. The applicant’s signature and date of signing; 2. A floor plan, which is drawn to approximate scale and may be neatly hand-drawn, of each building where the funeral establishment will be located, showing the function of each room; 3. A copy of the business organization’s articles of incorporation, articles of organization, or partnership documents, if applicable, and percentage ownership of each listed individual; 4. Documentation for the applicant that complies with A.R.S. § 41-1080; 5. For each individual signing according to subsection (B)(1)(n), the individual’s fingerprints on a fingerprint card for the Department’s criminal history check authorized in A.R.S. § 32-1383(B) that includes: a. The individual’s first name; middle initial, if applicable; and last name; b. The individual’s signature; c. If different from the individual, the signature of the individual physically rolling the individual’s fingerprints; d. The individual’s address; e. If applicable, the individual’s surname before marriage and any names previously used by the individual; f. The individual’s date of birth; g. The individual’s Social Security number; h. The individual’s citizenship status; i. The individual’s gender; j. The individual’s race; k. The individual’s height; l. The individual’s weight; m. The individual’s hair color; n. The individual’s eye color; o. The individual’s place of birth; and p. The date the individual’s fingerprints were rolled; 6. An attestation, in a Department-provided format, by the responsible funeral director including: a. The name and license number of the responsible funeral director; b. The name and physical address of the funeral establishment; c. The start date as responsible funeral director; d. Whether the contact email address for the funeral establishment is changing and, if so, the new contact email address for the funeral establishment; e. A statement that the responsible funeral director: i. Is licensed under Article 2 of this Subchapter; ii. Is familiar with the requirements in A.R.S. Title 32, Chapter 12, and the rules in this Subchapter; iii. Accepts responsibility for the operation of and services provided by the funeral establishment; and iv. Will ensure that the funeral establishment will be equipped and operated according to the requirements in A.R.S. Title 32, Chapter 12, and the rules in this Subchapter; and f. The responsible funeral director’s signature and date of signing; 7. If requesting an interim permit, documentation confirming the date of the change of ownership of the funeral establishment, including the signatures and dates of signing for both parties to the change of ownership; 8. If not planning to embalm on-site, a copy of the contract required in R9-9B-304(I)(1); 9. If applicable, documentation that shows that the applicant is in good standing with the Arizona Corporation Commission; and 10. The applicable fees in R9-9B-103(A) and (D)(1). C. Upon receipt of the application in subsection (B), the Department shall conduct an inspection of the funeral establishment. D. The Department shall issue or deny a license or interim permit, as applicable, to an applicant as specified in R9-9B-102. E. At least seven calendar days before the expiration of an interim permit, a funeral establishment with an interim permit may request an extension of the interim permit, according to A.R.S. § 32-1388, by submitting to the Department an application that contains: 1. The funeral establishment’s name, mailing address, email address, and telephone number; 2. The number associated with the interim permit; 3. A justification for why the extension of the interim permit is needed; and 4. The applicant’s signature and date of signing. F. Upon receipt of an application for an extension of an interim permit according to subsection (E), the Department shall issue or deny an extension of the interim permit to a funeral establishment as specified in R9-9B-102.