Form 4 Md PDF Details

Md Form 4 is a document that all business entities must file with the Maryland Secretary of State in order to register their company and receive authority to conduct business in Maryland. The form must be filed within 120 days of the company's formation. This article will provide an overview of the information required on Md Form 4, as well as instructions on how to complete and submit the form. If you're starting or doing business in Maryland, you'll need to file Md Form 4 with the state Secretary of State. This article provides an overview of what's required on the form, along with step-by-step instructions for completing and submitting it. Filing this form is essential for registering your company and receiving authority to do business in Maryland. So if you're new to doing business here, make sure you don't overlook this important step!

QuestionAnswer
Form NameForm 4 Md
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesMD_Form_4 oklahoma verification of clinical clerkship form

Form Preview Example

FORM #4 (MD)

Oklahoma State Board of Medical Licensure and Supervision

P.O. Box 18256, Oklahoma City, OK 73154-0256

VERIFICATION OF CLINICAL CLERKSHIP

In the event a foreign medical school utilized clerkships in the United States, its territories or possessions, and the applicant graduated from medical school after July 1, 2003, such clerkships shall have been performed in hospitals and schools that have programs accredited by the Accreditation Council for Graduate Medical Education (ACGME).

One form must be completed and mailed directly to the Board for each clerkship.

This is to certify that__________________________________;

____ ____ ____ / ____ ____ / ____ ____ ____ ____,

Student’s Name

U.S. Social Security Number

____________________________ a student of _______________________________________________________________

Date of BirthMedical School

Completed a clerkship offered by __________________________________________________________________________

Name of Facility

_____________________________________________________________________________________________________

 

 

 

Address of Facility

 

 

From________________________________________

through _________________________________ in the clinical area

Month

Day

Year

Month

Day

Year

Of____________________________________________________.

Clinical Area

This facility has programs that are accredited by ACGME in the areas of ____________________________________________.

Specialty

I, ___________________________________________, swear or affirm that I am/was the individual facility program director or

instructor for the student named above during the clerkship indicated and that I have carefully read and completed this form and that the statements made herein are accurate.

 

___________________________________________________________

Institution

Type or Print Name of Facility Program Director or Instructor

 

Seal

 

 

 

 

___________________________________________________________

 

Address

 

 

 

___________________________________________________________

 

City

State

Zip Code

 

_____________________

________________________________

 

Telephone Number

Signature

 

In the absence of an official institution seal, the Facility Program Director or Instructor’s signature must be notarized.

Signed and sworn before me this ________ day of ____________________(Month) _____________(Year).

 

_____________________________________________________________

 

Notary Public Signature

Notary

 

Seal

My Commission Expires:_________________________________________

How to Edit Form 4 Md Online for Free

With the online PDF editor by FormsPal, you'll be able to complete or change Form 4 Md right here. In order to make our editor better and easier to use, we continuously design new features, bearing in mind feedback coming from our users. This is what you would want to do to start:

Step 1: Click on the "Get Form" button above on this webpage to access our PDF editor.

Step 2: This tool provides the ability to change your PDF in various ways. Change it by writing any text, correct original content, and add a signature - all at your convenience!

It is actually easy to fill out the form using out detailed tutorial! This is what you want to do:

1. Before anything else, while completing the Form 4 Md, begin with the page that features the subsequent fields:

Filling in segment 1 in Form 4 Md

2. Once your current task is complete, take the next step – fill out all of these fields - This is to certify that a student, My Commission Expires, Type or Print Name of Facility, Notary Public Signature, City, Address, Institution Seal, Signature, Telephone Number, Notary Seal, Zip Code, and State with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Form 4 Md conclusion process shown (part 2)

People who work with this document often make mistakes while filling in Notary Seal in this section. You need to read twice what you type in right here.

Step 3: Prior to finalizing this document, ensure that all form fields have been filled out correctly. As soon as you think it is all fine, press “Done." Make a 7-day free trial account at FormsPal and get immediate access to Form 4 Md - downloadable, emailable, and editable from your FormsPal account. FormsPal provides safe document editor devoid of personal information record-keeping or sharing. Be assured that your information is in good hands here!