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TEXAS BOARD OF NURSING 333 GUADALUPE 3-460 AUSTIN TEXAS 78701-3944 512 305-7400 - 512 305-7401 FAX SWORN DECLARATION OF PRIMARY STATE OF RESIDENCE NAME ADDRESS CITY STATE ZIP RN/LVN LICENSE SSN DATE OF BIRTH E-Mail Address Yes No Business Fax Number Are you currently employed in the U.S. Military Active Duty or the U.S. Federal Government In accordance with the Nurse Practice Act Texas Occupations Code Chapter 304. 001 Nurse Licensure Compact and 22 TAC 220. 2 I declare the State of as my primary state of residence and that such constitutes my permanent and principal home for legal purposes. Primary state of residence is defined as the state of a person s declared fixed permanent and principal home for legal purposes domicile. I intend to practice in the state s of List up to 10 states e*g* Texas Arkansas Maryland New Mexico etc* Signature Date Revised 10/2007. 001 Nurse Licensure Compact and 22 TAC 220. 2 I declare the State of as my primary state of residence and that such constitute....

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How to fill out the Declaration Of Residence online

Filling out the Declaration Of Residence is an essential step for ensuring your primary state of residence is recorded accurately. This guide will help you navigate the process online, providing clear and detailed instructions for each section of the form.

Follow the steps to complete the Declaration Of Residence online.

  1. Click ‘Get Form’ button to obtain the form and open it in an editor.
  2. Begin by entering your name in the designated field. Ensure it is spelled correctly, as it will be used for official purposes.
  3. Next, fill in your address, including the street number and name, city, state, and ZIP code. Double-check for accuracy to avoid any processing issues.
  4. Provide your RN/LVN license number. This is crucial for verifying your credentials.
  5. Enter your Social Security Number (SSN). Ensure that you handle this information with care, as it is sensitive data.
  6. Include your date of birth in the appropriate format. This helps in the identification process.
  7. If applicable, enter your email address and business fax number. Indicating whether you are currently employed in the U.S. Military (Active Duty) or the U.S. Federal Government is essential.
  8. In the declaration statement, write down your primary state of residence. This identifies where your permanent home is located.
  9. List the states where you intend to practice up to a maximum of ten. Ensure to include each state name clearly.
  10. Finally, sign and date the form at the bottom. This signature serves as a declaration of the information provided.
  11. Once completed, you can save the changes, download, print, or share the form as needed.

Complete your Declaration Of Residence online today to ensure your residency is properly recorded.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232