Form 16 029 request for identicard 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the 'Facility Name' and 'Contact Person' fields. Ensure that all columns are completed accurately.
3. Enter your 'Telephone Number' and 'Return Email Address' for communication purposes.
4. Provide your complete address, including 'City', 'State', and 'ZIP Code'.
5. In the section for the employee's information, input the 'Employee’s Name' (Last, First, Middle Initial), 'Date of Birth', and 'Social Security Number'.
6. Fill in the 'NAC or NAR Credential Number' if applicable, followed by details of previous employment as an NAC.
7. For each previous employment entry, include both the first and last dates employed using the format MM/DD/YY.
8. Review all entries for accuracy before submitting your completed inquiry form via email to obraregistry@dshs.wa.gov.

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