Get Facility/license - State Ar

Filling out the Facility/license form for the state of Arkansas is an essential step in ensuring compliance with local regulations. This guide will walk you through the necessary steps to complete the form accurately and efficiently.

Follow the steps to fill out the Facility/license - State Ar form online.

1. Press the ‘Get Form’ button to access the form and open it in your preferred document editor.
2. Begin by entering the facility name in the 'Facility requesting report' section. Ensure all details are spelled correctly.
3. Fill in the name of the licensing specialist who is requesting the criminal record check.
4. Provide the complete mailing address, including city, state, and zip code.
5. Enter the telephone number as it pertains to the facility.
6. Input the name of the facility director along with their telephone number.
7. Record the date of your request in the specified format.
8. Detail the county and the name of the individual to be checked, making sure to include all required prefixes such as last name, first name, middle name, and maiden name.
9. Include the individual's date of birth and social security number, ensuring accuracy in the format provided.
10. If applicable, input the driver's license or government ID number.
11. Fill in the phone number of the individual to be verified.
12. Specify the individual's race and sex, selecting the appropriate options.
13. Answer the question about residency in Arkansas for the past five years, circling yes or no as applicable.
14. Complete the full residential address, ensuring all parts are filled out accurately.
15. Indicate the place of employment for the individual being checked.
16. Respond to the question regarding any prior convictions, circling yes or no as appropriate. If yes, provide a detailed description as instructed.
17. Read and complete the authorization section, including the signature of the individual being checked and the date.
18. Lastly, leave the state police use section blank, as it is reserved for their use only.
19. After completing the form, review all entries for accuracy. You can now save your changes, download, print, or share the form as needed.

Complete your Facility/license form online today to ensure a smooth application process.