Texas Form 5506 NAR is used to report the sale or exchange of certain types of property. This form must be filed within 30 days after the date of the sale or exchange. The information reported on this form can help you avoid paying taxes on the property you sell or exchange. Read on to learn more about Texas Form 5506 NAR and how to file it.
This information can help you understand better the details of the texas form 5506 nar before you start filling it out.
| Question | Answer |
|---|---|
| Form Name | Texas Form 5506 Nar |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | texas nurse aide renewal form, cna renewal form, nurse aide registry texas, cna renewal forms application |
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Form |
Texas Nurse Aide Registry |
March |
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Employment Verification
Please complete document in blue ink only.
Section 1. To be completed by Nurse Aide - Please read the following instructions before completing this form.
The Nurse Aide Registry has implemented a new online system called Credential Manager. Before completing this form, you are required to verify your information in the new system at: https://i7lp.integral7.com/txna. Click on "Up For Renewal but Never Logged In" and complete your registration. Once you have registered, please list your identification number here:
I.D. No.:
●Complete all information in Section 1 and sign to verify that the information provided is correct.
●Attach a legible photocopy of a picture identification that shows your birth date and the correct spelling of your name.
●Obtain employer verification (Section 2). Form must be mailed to: Texas Nurse Aide Registry, P.O. Box 149030, Mail Code
Note: A list of approved
The Texas Nurse Aide Registry will return (without action) incomplete requests and requests without the required documents.
Name of Applicant (Last, First, Middle) |
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Maiden Name (if applicable) |
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Mailing Address (Street or P.O. Box) |
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City |
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ZIP Code |
Daytime Area Code and Telephone No. |
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Social Security No. |
Sex |
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Date of Birth (mm/dd/yyyy) |
Email Address |
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Male |
Female |
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CNA Certificate No. |
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Verification of requirements for Nurse Aide Recertification
Are you listed on the Employee Misconduct Registry (EMR) as unemployable?
Have you been found to have a conviction of a criminal offense listed in Texas Health and Safety Code, §250.006? If yes, give date of conviction.
Yes Yes
No No
Have you completed 24 hours of
Yes
No
Note:
Signature – Nurse Aide |
Date |
Section 2. To be completed by the Employer - Instructions:
●This section must be completed by the facility program director, official keeper of records or actual employer.
●Notarize employer signature at the bottom of this section and return to nurse aide.
Employer Name or Company Name
Mailing Address (Street or P.O. Box) |
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Daytime Area Code and Telephone No.
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ZIP Code |
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I certify that the individual named above is/was employed by me as a nurse aide and performed |
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from (mm/dd/yyyy) |
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to (mm/dd/yyyy) |
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and that I am not aware of any disqualifying misconduct. |
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Signature – Employer |
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Date |
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Sworn and subscribed to me on this |
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day of |
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in |
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County, in the state of |
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Place Notary Seal or Stamp Here
Signature – Notary Public
Date Commission Expires
Tampering with or attempting to falsify a government record as such a nurse aide certificate is a
Form
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