Residence declaration form 2026

1. Click ‘Get Form’ to open the residence declaration form in the editor.
2. Begin by entering your full name in the designated NAME field at the top of the form.
3. Fill in your complete address, including street, city, state, and ZIP code in the respective fields.
4. Provide your RN/LVN license number and Social Security Number (SSN) in the specified sections.
5. Enter your date of birth accurately to ensure proper identification.
6. Indicate whether you are currently employed in the U.S. Military or Federal Government by checking 'Yes' or 'No'.
7. Declare your primary state of residence by filling in the blank provided and affirming it as your permanent home for legal purposes.
8. List up to ten states where you intend to practice nursing in the provided section.
9. Finally, sign and date the form at the bottom to validate your declaration.

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