21 NCAC 34B .0610          FUNERAL ESTABLISHMENT PERMIT AND BRANCH ESTABLISHMENT RENEWAL FORM

All funeral establishments and branch establishments shall annually submit a renewal application on forms provided by the Board that are available on the Board's website, ncbfs.org. All renewal applications for a funeral establishment or a branch establishment permit shall contain the following:

(1)           The legal name of the individual or entity that owns the funeral establishment;

(2)           The email address, physical address, mailing address, phone number(s), and facsimile number of the funeral establishment;

(3)           Other names under which the funeral establishment conducts business;

(4)           Whether the entity or individual owning the unaffiliated practice is a sole proprietorship, partnership, corporation, or limited liability company;

(5)           If owned by a sole proprietor, the legal name of the sole proprietor;

(6)           If owned by a partnership, the name of each partner and his or her respective ownership interests;

(7)           If owned by a corporation, the name of each corporate officer and his or her position and his or her respective ownership interest;

(8)           If owned by a limited liability company, the name of each member and his or her respective percentage of ownership;

(9)           Whether the establishment has continuously held a funeral establishment permit since January 1, 1988;

(10)         Whether more than fifty percent of the ownership interest has changed at any time since last year's renewal;

(11)         Whether the preparation room within the funeral establishment complies with the requirements of G.S. 90-210.27A(a) and whether any changes have been made to the preparation room since the previous renewal application;

(12)         Whether embalming will be performed in an embalming facility located outside of the funeral establishment and, if so, the name and address of the location at which embalming will be performed;

(13)         The name and license number of the individual who will serve as the licensed location manager for the funeral establishment in accordance with G.S. 90-210.25(d)(1);

(14)         The facility at which refrigeration of unembalmed human remains on behalf of the funeral establishment will occur, if refrigeration will be performed in an off-site facility;

(15)         The names, license type and license number of each funeral director, funeral service licensee, and embalmber working for the establishment and whether said licensee is working on a full-time, part-time, or per case basis;

(16)         Whether the applicant currently is in good standing with the North Carolina Secretary of State and, if so, documentation to establish proof of the same;

(17)         Whether, since the previous renewal application, the applicant has been the subject of any investigation for employee misclassification and, if so, the results of the investigation;

(18)         The licensed manager's notarized signature to certify that:

(a)           he or she has prepared the application and has read the answers;

(b)           the information provided in the application is true;

(c)           the applicant has read and understands the public notice statement on employee misclassification that is set forth in the application and has disclosed any investigations for employee misclassification, and its results, since the last renewal application, as prescribed by G.S. 143-789; and

(d)           he or she understands that any credential issued shall be governed by the provisions of Article 13A, Chapter 90 of the North Carolina General Statutes and the rules promulgated by the Board.

(19)         If requested by the Board, the signature of each owner, partner, manager, member, operator, and officer of the business entity applying for renewal of licensure, consenting to the Board's ability to conduct a background check on his or her criminal history; and

(20)         The application fee, as prescribed by G.S. 90-210.28 and 21 NCAC 34A .0201. If the application fee is dishonored by the licensee's drawee bank for any reason, the Board shall suspend the license until the renewal fees and non-sufficient fund charges are paid.

History Note:        Authority G.S. 90‑210.23(a); 90‑210.25(d)(3);

Eff. February 1, 1976;

Readopted Eff. September 27, 1977;

Amended Eff. December 1, 2004; September 1, 1979;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. August 19, 2017;

Temporary Amendment Eff. November 7, 2025.