Intermediate Care Facilities for the Mentally Retarded
Duplicate License

The form may be completed on-line, however, it cannot be submitted via e-mail due to the fact that all applications and forms require original signatures. If you complete the form on-line, you must print the form and mail it to the address below.

A duplicate or reissued license is available for a fee of $10.00. Duplicate/Reissue Form

Licensing & Regulatory Affairs
ICF/MR
PO Box 94986
Lincoln, NE 68508-9486