Exemption Request Form Templates

This form is used for requesting an exemption from state contract requirements in North Dakota.

This Form is used for requesting a Prior Authorization or a Preferred Drug List exemption in Wisconsin. It provides instructions on how to complete the form and submit it for review.

This Form is used to request an exemption from the Prior Authorization/Preferred Drug List (PA/PDL) requirement in Wisconsin.

This form is used for submitting a request for an unreasonable hardship exemption in the City of Berkeley, California.

This document is a request for exemption for a ventless hood in the County of San Diego, California. It is used to seek permission to deviate from the standard requirement of having a venting system for a hood in a commercial establishment.

This document is for requesting an exemption for a clamshell grill in San Diego County, California.

This document is a request for exemption for an electric convection oven in the County of San Diego, California.

This document outlines the requirements and checklist for requesting an exemption from the design review for a site plan permit in San Diego County, California.

This document is used for requesting an exemption from property taxes for vacant properties in the City of South Euclid, Ohio.

This document is for requesting a tax exemption for a non-profit organization in Blackman Charter Township, Michigan.

This document is used to request an exemption for public records in Okaloosa County, Florida. It allows individuals to request that certain information be withheld from public disclosure.

This document is a request for exemption from the clean diesel technology requirement for a diesel vehicle in the City of Philadelphia, Pennsylvania.

This Form is used for requesting an exemption from licensure for a home for the aged in Michigan.

This form is used for requesting a medical exemption from the Covid-19 vaccination in South Carolina.

This form is used for residents of Virginia to request a disaster exemption.

This Form is used for requesting an exemption from prior authorization requirements for certain imaging services in Wisconsin, including Computed Tomography (CT), Magnetic Resonance (MR), and Magnetic Resonance Elastography (MRE) imaging services.

This Form is used for requesting an exemption for hand-held dental equipment in South Carolina.

This form is used for requesting exemption from having certain records made available to the public in the state of Florida.

This Form is used for requesting an exemption determination in the state of Tennessee.

This form is used for requesting an exemption from disclosing personal information of certain government attorneys in Oregon.

This document is a request for an exemption in Harris County, Texas for individuals with physical or mental impairments. It is used to seek an exemption from certain requirements or criteria based on these impairments.

This Form is used for requesting a hardship exemption in the state of Oregon.

This form is used for requesting an exemption for "only willing and qualified provider (OWQP) requests" from the New Hampshire Bureau of Developmental Services.

This document is an exemption request form for the Utility Users Tax in the City of San Jose, California. It is used to request exemption from paying the tax for utility usage.