The Clerk will assign a judge to your case and give you the contact information for the Bailiff, who will schedule your court date and assign you a case number. It looks like your browser does not have JavaScript enabled. Next, fill out the Legal Notice for Name Change of a Minor Child (DC 6-11-2) and have it published once a week for a minimum of two (2) consecutive weeks by a newspaper with circulation in your county. Supporting documents include: We partner with the boards of pharmacy to protect public health. Name of facility: This name must match the name listed on your home state license. Page one of this application should reflect the new title. The judge will sign and date this document if your name change is approved. Once their marriage or divorce is final, they will be able to obtain a document which proves that their name has been legally changed. Information; Old Address; New Mailing Address; New Business Address; New Home Address; Last Name (as it appears on your license certificate) First Name (as it appears on your license certificate) Two-Letter License Prefix (i.e. Once completed, deliver the registration form by hand or mail to the office of your local County Clerk or Election Commissioner. Maiden or Other License or Registration Number Last four digits of your Social Security Number XXX-XX- Contact number Email address CHANGE OF NAME **You must submit a copy of a legal document verifying your new name. If you are transferring your license to Nebraska, you must pass the MPJE prior to submitting your Licensure Transfer application. Changing a last name when getting married is the most common reason for people to get their name changed. Change of Address or Name - Notification to Board (a) Within 30 days after changing his or her address of record with the board or after changing his or her name according to law, a pharmacist, intern pharmacist, technician, or designated representative shall notify the executive officer of the board of the change of address or change of name. They must sign this document in the presence of a notary public, who needs to provide their verification before the document is filed with the District Court. As relayed in the Minor Child Name Change Hearing Instructions (DC 6-11-6), you will be called upon to testify appropriately to your situation and present any documents that are relevant to your case. Once you have received your marriage license and your wedding ceremony has taken place, the marriage officiant will sign the license and submit it to the county clerk. LanguageLinc Interpretation Services is a pool of highly trained Interpreters and Translators providing service in Nebraska. Be sure to inform yourself as to what the cost of filing your petition will be and what the accepted methods of payment are at your District Court. Once your divorce is final, you will be able to obtain a divorce certificate. Permit Number . Agendas & Minutes; List of Boards; Membership and Responsibilities; Requirements & Vacancies; State Board of Health; Other. Be a resident of your county for a minimum of one (1) year 4. If you attempt to change your name after your marriage has already taken place, you will need to file a Petition for Name Change with your District Court. You must return the original hard copy of your license and submit a copy of supporting documents. Create a high quality document online now! This form must be completed and returned to the Board office within ten (10) days of employment change. Lincoln NE 68508Hours: Monday - Friday 8:00 a.m. - 5:00 p.m. Closed federal holidays. or money order made payable to the SC Board of Pharmacy. You will be asked to enter your new name and your previous registration information into the online form. If the subject is under nineteen (19) years old, their parent must file the petition on their behalf. RENEWAL UPDATE: Per Executive Order 20-10, license renewal is being deferred for certain license types.Licenses for these license types will not expire until further notice and when the COVID-19 State of Emergency is lifted; therefore, expiration dates for these licenses will appear as 0000-00-00 on License Lookup unless the licensee has renewed. You will be called upon to testify at which point you must make the declarations outlined within the Name Change Hearing Instructions (DC 6-9a). Completing the Pharmacy Technician Name Change form, which includes your new name, clearly printed or typed exactly as it is to appear on the Registration in Board records; 2. The Clerk will give you the phone number of the Bailiff whom you must contact in order to arrange your hearing date and be assigned a case number. Last Name First Name M.I. The fee is not refundable. We must have an original signature and fee to process. If you have any questions, please contact the Licensure Unit by email, or by phone at (402) 471-2115. You will be asked to pay immediately in order for your petition to be filed (most districts will accept credit cards as a payment method). You should verify that the court has received your proof of publication in advance of your hearing date. The following are acceptable name change verification documents: (1) Marriage certificate; Before their name can be changed, petitioner’s will also need to write a legal notice of their name change and have this notice published in a local newspaper. You will be invoiced by the newspaper and required to pay a publication fee. Note for Nebraska Candidates for Licensure. This is called Limited Scope Representation. Name Change or Reissuance; Renew a Facility License; Renew a Professional License; Board Information. At this juncture, you can review the Checklist for Name Change of a Minor Child (DC 6-11a) to ensure that you have completed all of the necessary steps up to this point. Applications received without the proper fee will not be processed. New Application Process Begun May 1, 2018 – Prior to submission of an application for a Nebraska Pharmacist license, individuals must have successfully completed the NAPLEX and MPJE examinations with scores of at least 75. It is recommended that you contact the Clerk’s office in advance to verify their procedure for filing a Petition for Name Change. This document acts as legal service of notice regarding your name change, and you must published it in a local newspaper. Fill out all of the blank fields except for the date and signature fields. All rights reserved. PACE Alliance in 1985 and owned by 19 State Pharmacy Organizations, is a national independent pharmacy support organization. If you are requesting changes through paper application, you need your: License number; Social Security Number; Date of birth; For a name change. The fee for a pharmacy license is $100. Sacramento, CA 9583 3 Gavin Newsom, Governor . ARTICLE II . A returned check fee of up to $30, or an amount A returned check fee of up to $30, or an amount specified by … Licenses due to be renewed during the declared emergency will be extended until 30 days after Executive Order 20-10 is no longer in effect. Board of Directors Networks ... give back, and grow. Name of Pharmacy . If there is a court hearing, you must attend and bring copies of all of your completed name change documents. Connect with your board. Updating one’s voter information can be accomplished online, by mail, or in person. First, you must fill out the Petition for Name Change of a Minor Child (DC 6-11-1) except for the case number; this will be assigned to your case later. Pharmacy Address . Attn: [Profession, Facility type, or Children's Services], Nebraska State Office Building301 Centennial Mall South14th & M Streets, 1st Floor. You must obtain certified copies of this signed document to use as your proof of name change when you update your social security, driver’s license, account holder information, etc. TEXAS STATE BOARD OF PHARMACY 333 Guadalupe Street, Suite 3-500 Austin, Texas 78701 512-305-8000 www.pharmacy.texas.gov Request to Change the Name or Location of Pharmacy License Instructions Instructions: This form should be submitted if a pharmacy is changing their Business or DBA Name or if the pharmacy is physically changing location or suite numbers. Obtain the Petition for Name Change (DC 6-9-1) and fill out the entire document. If the child’s other parent consents to the name change, you should give them the Consent for the Name Change of a Minor Child (DC 6-11-3) to fill out. New Pharmacy Services Out-of-State Application : Reinstatement/Change of Ownership Application : Change of Name or Address Form : Duplicate License/Registration Request : Change of Supervising Pharmacist By law you are required to apply for a new ID within sixty (60) days of your legal name change coming into effect. To apply for a replacement Driver's License, Permit or State Identification Card, a resident must submit the following: Acceptable Proof of Identification - Nebraska requires one form of identification that includes name and date of birth to obtain a replacement driver license, permit or State ID Card. Publication must occur for a minimum of one (1) time per week for a period of four (4) consecutive weeks. Email this form to . Through the work of the boards of pharmacy, NABP members protect the public health by promoting the highest standards of pharmacy practice. APPLICATION FOR CHANGE OF PHARMACIST- IN-CHARGE (PIC) The owner of a pharmacy and the PIC are required by California law … If there are no objections or complications with your petition, it is likely that the Judge will approve your child’s name change without trial. Board of Pharmacy Change Address. Information; Old Address ... Change Address. FAILURE TO COMPLETE THE ENTIRE APPLICATION WILL RESULT IN DELAYS FOR YOUR … Please print the following information: Name of New Pharmacist-in-Charge. NEVADA STATE BOARD OF PHARMACY 985 DAMONTE RANCH PKWY, SUITE 206 – RENO, NV 89521 - (775) 850-1440 This application cannot be returned by fax or email. In order to file a Petition for Name Change in Nebraska, you must meet the following requirements: 1. Connect with your board, access state newsletters, and learn about our shared mission. Contact your local newspapers to verify their fees for publishing a notice of name change and arrange for the publication of your Legal Notice of Name Change. But we don’t just report information. On this form, you will provide your personal information, your desired name, and your reasons for requesting a name change. Once you have scheduled a court date and have been assigned a case number from the Bailiff, you will need to fill out the Legal Notice of Name Change (DC 6-9-2). This includes name, address and employment. CCXXXXX, MZXXXXX, DIXXXXXX) The two-letter prefix is found on your license … The Decree for Name Change of a Minor (DC 6-11-5) is the document which the Judge will sign and date if your petition is accepted. If you have a vehicle title in your previous name, you should renew your title or obtain a duplicate with your new name. This affidavit will be attached to the published notice and filed with the Clerk. Once all of the above steps have been completed, and there is no objection from the public or reason for suspicion on behalf of the court, the judge will authorize your name change by signing your Decree of Name Change. to the court. You will also need to present evidence of your former name (birth certificate, etc.) A graduate of a pharmacy program located outside the United States which is not accredited; he or she has successfully passed equivalency examinations approved by the Board of Pharmacy A pharmacist intern may compound and dispense drugs or devices and fill prescriptions only in the presence of and under the immediate personal supervision of a licensed pharmacist. The licensee must notify the Department in writing within 5 working days there. Change in the name of the certified mail in case you need to navigate to the published notice and with! Is $ 100, Springfi eld, IL 62786. requesting a name,! 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