| (a) (Here give name and complete mailing address of applicant on whose behalf the application if filed, hereinafter called applicant.) (b) Caption. Applicant hereby seeks (Here make specific reference to the rule or rules which it is proposed to establish, change or amend, so that it or they may be readily identified, prepared in a manner to indicate the words to be added or deleted from the current text, if any.) (c) Proposed change. (Here make reference to an exhibit to be attached to and incorporated by reference to the petition, the said exhibit to show the amendment providing for the proposed new provision, rule, regulation, rate practice or other change, including the proposed effective date, application and all other necessary information, in the exact form in which it is to be published, adopted or promulgated.) (d) Justification. (Here submit the justification for the proposed action in narrative form
with sufficient information to inform the agency and any interested party fully of the facts upon which applicant relies.) (e) Resume or concise abstract. (Here file with the petition a concise but complete resume or abstract of the information required in subsections (a), (b), (c), and (d) of this section.) (f) Signature. Respectfully submitted, (Applicant) (Attorney or representative) (Complete address)
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