Get Tx Lic-021 2021-2026

Filling out the TX LIC-021 form is an essential step for managing officers applying for a pharmacy license in Texas. This guide will provide clear and supportive instructions to help you complete the form accurately and efficiently online.

Follow the steps to complete the TX LIC-021 online.

1. Click ‘Get Form’ button to obtain the form and open it in your chosen editor.
2. Begin by entering the pharmacy information in the designated sections. Ensure that the pharmacy name, address, and any other required details match exactly with Box 2 on the Pharmacy Information Form.
3. Next, fill in the managing officer information. Accurate details are required for the first name, middle name, date of birth, last name, title, and social security number. If applicable, include the Texas pharmacist license number here.
4. Provide the home address, which will be treated as the confidential address, and an alternate public address. Both addresses must include street, city, state, and zip/postal code.
5. Include your contact information, which involves entering a phone number and email address, ensuring that they are accurate and current.
6. If you are an officer or owner in additional pharmacies, list them in the specific section provided. Include the pharmacy name, license number, state, and your title or position at each location.
7. Answer the mandatory questions regarding professional disciplinary actions and criminal offenses. Be thorough and honest; include all pertinent information as required.
8. Once all sections are complete, review the form for any errors or missing information. Make any necessary corrections.
9. Finally, after ensuring the accuracy of the content, print the form. Sign it in front of a notary public as required, and remember that each managing officer must submit their application in original form.
10. After notarization, submit the completed form as part of your pharmacy application package. Don’t forget to include copies of all required documentation such as the driver’s license and social security card.

Complete your TX LIC-021 form online now to ensure a smooth licensure process.