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Compact Licensure Declaration of Residency General License Informational on professional license: Address on professional license: Nurse Compact Information Declared State of Permanent Residency:
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How to fill out compact licensure declaration of

01
Obtain a copy of the compact licensure declaration form.
02
Read through the instructions and requirements listed on the form.
03
Fill out your personal information accurately, including your full name, contact information, and any applicable identification numbers.
04
Provide details about your current nursing license, including the state in which it was issued and the license number.
05
Declare any criminal convictions or disciplinary actions related to your nursing practice, if applicable.
06
Sign and date the declaration form.
07
Submit the completed form as required, either by mail or electronic submission, to the appropriate licensing authority.
08
Keep a copy of the filled-out declaration form for your records.

Who needs compact licensure declaration of?

01
Nurses who have a multistate license issued by a Nursing License Compact (NLC) member state may need to fill out a compact licensure declaration form when changing their primary state of residence.
02
Nurses who wish to practice in a different NLC member state other than their primary state of residence may also need to complete the compact licensure declaration form.
03
It is important to consult the nursing licensing board or regulatory agency of the specific state for accurate information on who needs to fill out the compact licensure declaration form.
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Compact licensure declaration is a document declaring an individual's eligibility to practice in multiple states under the Nurse Licensure Compact (NLC).
Nurses who hold a multi-state license under the NLC are required to file the compact licensure declaration.
The compact licensure declaration can be filled out online through the Nursys system.
The purpose of the compact licensure declaration is to ensure compliance with the regulations of the Nurse Licensure Compact.
The compact licensure declaration requires information such as personal details, license number, and states where the individual holds or has applied for a license.
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