Get Ak Form 08-4067 2022-2025

Filling out the AK Form 08-4067 online can be straightforward when you follow the provided instructions carefully. This guide will walk you through the necessary steps to successfully complete your application for the reinstatement of your nursing license.

Follow the steps to complete your application efficiently.

1. Click the ‘Get Form’ button to initiate and open the form in your chosen online editor.
2. Fill in your full legal name and any other names you have used. This includes your maiden name and any aliases. Make sure to provide certified true copies of the documentation showing any legal name changes if necessary.
3. Enter your mailing address accurately, including P.O. Box or street, city, state, and zip code.
4. Provide your date of birth and choose your preferred method for receiving correspondence, which can be electronically or through traditional mail.
5. Complete the application fee section by selecting the appropriate fees: $100 for the penalty fee, $200 for the license fee, and $75 for fingerprint processing, totaling $375.
6. List all other nursing licenses or permits you currently hold or have held since your Alaska license lapsed. Include the state license number and status (active, lapsed, etc.).
7. Detail your nursing-related employment for the past five years, starting with your most recent job. Ensure that one of the listed employers is the one verified on the Verification of Employment form.
8. Indicate any continuing education or professional activities completed within the last two years that satisfy the continuing competency requirements.
9. Answer the professional fitness questions truthfully. If you select 'yes' to any question, provide a detailed explanation and attach relevant documentation.
10. Finalize your application by signing where indicated and obtaining notarization. Ensure all information is correct and complete.
11. Once completed, save your changes, and consider downloading or printing the form for your records. Be prepared to share the application as needed.

Take action today by completing the AK Form 08-4067 online and ensure your nursing license reinstatement process is on the right track.