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REGISTRATION HEALTH CARE PERSONNEL EDUCATION Phone: (919) 8553793 FOR and CREDENTIALING SECTION Medication Aide Testing website: http://mats.dhhs.state.nc.us/ WRITTEN Fax: (919) 7339764 EXAMS DSR

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How to fill out registration bform 4655b for

How to fill out registration bform 4655b:

01

Step one: Enter your personal information

1.1

Start by writing your full name in the designated space. Make sure to use your legal name as it appears on your identification documents.

1.2

Provide your date of birth, gender, and nationality.

1.3

Fill in your complete residential address, including the street, city, state, and postal code.

02

Step two: Mention your contact details

2.1

Enter your valid email address and phone number.

2.2

If you have an alternative contact number, you can include it as well.

03

Step three: Specify your employment information

3.1

State your current occupation and the name of the company you work for, if applicable.

3.2

Indicate your position or job title.

3.3

If you are self-employed, write "self-employed" in the corresponding field.

04

Step four: Provide information about your background

4.1

If you have any criminal record, convictions, or pending charges, disclose them accurately.

4.2

Mention any citizenship or residency status you hold in other countries.

05

Step five: Declare the purpose of your registration

5.1

Select the appropriate option that accurately represents the purpose for which you are filling out the form. This could be related to employment, study, immigration, or other reasons.

06

Step six: Attach supporting documents

6.1

Check the specific requirements for documentation mentioned on the form. Typically, you will need to provide identification documents such as a passport or birth certificate. Include all necessary supporting documents as per the instructions.

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What is registration bform 4655b for?

Registration bform 4655b is for registering specific information with the relevant authority.

Who is required to file registration bform 4655b for?

Entities or individuals designated by the authority are required to file registration bform 4655b.

How to fill out registration bform 4655b for?

Registration bform 4655b should be filled out completely and accurately according to the instructions provided by the authority.

What is the purpose of registration bform 4655b for?

The purpose of registration bform 4655b is to ensure that certain information is properly documented and reported.

What information must be reported on registration bform 4655b for?

Registration bform 4655b may require details such as names, addresses, identification numbers, and other relevant data.

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