Get Ar920310z

Filling out the Ar920310z form is an essential step for individuals seeking a license through the Arkansas Department of Human Services. This guide will provide clear, step-by-step instructions to help you efficiently complete the form online.

Follow the steps to complete the Ar920310z form online.

1. Click 'Get Form' button to obtain the form and open it in the editor.
2. Enter the agency number, which is '0710', in the designated field.
3. Fill in the agency license number in the appropriate space.
4. Enter your legal name, including your last name, first name, and middle name. If applicable, include your maiden name.
5. Provide your email address to facilitate communication regarding the form.
6. Complete your current street address, including city, state, and ZIP code.
7. Input your date of birth and state of birth.
8. Indicate your age, race, and citizenship status.
9. Select your sex by choosing the appropriate option provided.
10. Fill in your social security number and your driver's license or state ID number.
11. Answer the question regarding any prior convictions, selecting 'Yes' or 'No' as applicable. If you answer 'Yes', you must provide details about the conviction.
12. Read and agree to the declaration at the end of the form, ensuring that all representations made are true and correct.
13. Sign and date the form in the designated area.
14. Complete the notary section, including space for the notary to sign and commission expiration date.
15. Provide consent for the Arkansas State Police to conduct a criminal record search, entering the name of the child welfare agency along with the representative's details.
16. Fill out the mailing address for the agency, including street, city, state, and ZIP code.
17. Once you have filled out all sections accurately, review the document for completeness, then save your changes, download, print, or share the form as needed.

Complete your documents online for a smooth application process.