761—12.2  (17A)  Petition for declaratory order.
	   12.2(1) Any person or agency may file with the department a petition for declaratory order. The subject matter of the petition must be within the primary jurisdiction of the department.
	   12.2(2) The petition must be submitted to the department’s rules administrator at the following address: Rules Administrator, Operations and Finance Division, Iowa Department of Transportation, 800 Lincoln Way, Ames, Iowa 50010.
	   12.2(3) The petition must be typewritten or legibly handwritten in ink and must substantially conform to the following form:
IOWA DEPARTMENT OF TRANSPORTATION
800 Lincoln Way, Ames, Iowa 50010	
PETITION BY (insert petitioner’s name)
FOR DECLARATORY ORDER ON
(insert number of statute, rule, etc.	and brief description of subject matter)	}	DOCKET NO.   	
PETITION FOR DECLARATORY
ORDER	
(In separate numbered paragraphs, the petition shall include the following.)
	      1. 	  The petitioner’s name, address and telephone number.
	      2. 	  The exact words, passages, sentences or paragraphs of statutes, rules, etc.	which are the subject of the inquiry.
	      3. 	  A clear, concise and complete statement of all relevant facts for which the order is requested.
	      4. 	  The uncertainties or conflicting interpretations which arise when the cited statutes, rules, etc.	are applied to the facts.
	      5. 	  (Optional) The interpretation urged based upon the facts set forth.
	      6. 	  The reasons for the petition and a full disclosure of the petitioner’s interest.
	      7. 	  Whether the petitioner is currently a party to a rule-making, contested case or judicial proceeding involving the controversy or uncertainty.
	      8. 	  The names and addresses, when known, of other persons who may be affected by the declaratory order.
	   12.2(4) The petition must be dated and signed by the petitioner or, if applicable, petitioner’s representative.
	   12.2(5) If applicable, the petition must also include the name, address, and telephone number of the petitioner’s representative and a statement indicating the person to whom communications concerning the petition should be directed.
	   12.2(6) The date of receipt of the petition is the day it reaches the department’s rules administrator. The administrator shall promptly send an acknowledgment of receipt to the petitioner or, if applicable, petitioner’s representative.
[ ARC 2231C , IAB 11/11/15, effective 12/16/15;    ARC 2889C , IAB 1/4/17, effective 2/8/17]