Get License Verification Form Oos506 - Op Nysed

Filling out the License Verification Form OOS506 is an essential step for individuals applying for pharmacy licenses in New York State. This guide will provide you with clear, step-by-step instructions to help you complete the form accurately and efficiently online.

Follow the steps to fill out the License Verification Form OOS506.

1. Click the ‘Get Form’ button to obtain the form and open it for editing.
2. In the first section, enter the Name of Applicant. This should include the full name of the individual whose license is being verified.
3. Next, provide the Address of the applicant. Ensure this includes the street address, city, state, and zip code.
4. Fill in the License/Permit Number. This is a unique identifier associated with the applicant's current license.
5. Enter the Effective Date of the license, which is the date the license was issued.
6. Provide the Expiration Date of the license to confirm when the license is set to expire.
7. Indicate the business type by checking one of the options: Pharmacy, Wholesaler Distributor, or Manufacturer.
8. Specify the State in which the license is valid by entering the state name.
9. Complete the section that verifies the license/permit is current and in good standing, which may require an authorized signature from the licensing agency.
10. Provide the Complete Name of the Licensing Agency responsible for the verification process.
11. Obtain the Signature of the authorized person from the licensing agency completing the form.
12. Enter the Contact Person's name and their Phone Number for any queries regarding the verification.
13. Imprint the Official State Seal if required, and ensure the Date of completion is also filled in.
14. Review the completed form for accuracy before proceeding to save your changes, download the form for your records, print it, or share it as needed.

Complete your License Verification Form OOS506 online to ensure a smooth application process.