A petition for waiver filed in accordance with this chapter must meet the requirements specified herein and must substantially conform to the following form:
* Why applying the rule would result in undue hardship to the petitioner;
* Why waiving the rule would not prejudice the substantial legal rights of any person;
* Whether the provisions of the rule subject to the waiver are specifically mandated by statute or another provision of law; and
* How substantially equal protection of public health, safety, and welfare will be afforded by a means other than that prescribed in the particular rule for which the waiver is requested.
I hereby attest to the accuracy and truthfulness of the above information.
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Petitioner's signature Date
Iowa Admin. Code r. 201-7.17