Get In State Form 55225 2017-2025

Filling out the IN State Form 55225, the Affidavit of Completion for the Pharmacy Technician Training and Education Program, is an essential step for individuals seeking to validate their training. This guide provides clear instructions to help you complete the form online efficiently.

Follow the steps to complete the form accurately.

1. Use the ‘Get Form’ button to access the required form and open it in your editing interface.
2. In the first section, enter the name of the qualifying pharmacist who will certify the training. Make sure to type or write clearly in ink if you are using a print version.
3. Next, fill in the name of the pharmacy technician applicant in the designated field, ensuring the spelling is accurate.
4. Provide the name of the Indiana Board of Pharmacy approved training program that the applicant has completed.
5. Input the program number assigned by the Indiana Board of Pharmacy in the appropriate section.
6. Enter the start date of the training program in the designated date field, using the month, day, and year format.
7. Record the completion date of the training program in the specified date field, also using the month, day, and year format.
8. The qualifying pharmacist must sign and date the form to affirm the information provided. Include their pharmacy license number and the name of the pharmacy.
9. If applicable, the pharmacy technician applicant should also provide their signature and date the document. Include their Technician-in-Training permit number if they have one.
10. Once all fields are completed, review the form for accuracy. Users can then save their changes, download, print, or share the completed form as needed.

Complete your documents online today for a streamlined submission process.