{"id":4324,"date":"2011-11-07T15:57:15","date_gmt":"2011-11-07T20:57:15","guid":{"rendered":"http:\/\/thedustininmansociety.com\/blog\/?p=4324"},"modified":"2011-11-07T16:54:45","modified_gmt":"2011-11-07T21:54:45","slug":"georgia-secretary-of-state-office-online-form-that-can-be-mailed-in-according-to-sos-clerk","status":"publish","type":"post","link":"https:\/\/www.thedustininmansociety.org\/blog\/2011\/11\/07\/georgia-secretary-of-state-office-online-form-that-can-be-mailed-in-according-to-sos-clerk\/","title":{"rendered":"Georgia Secretary of State office online immigration form that can be mailed in according to SOS clerk"},"content":{"rendered":"

If you apply for a professional license – in this case a nursing license – on the Georgia Secretary of State’s Website, you will see this online application.<\/strong><\/p>\n

“By submitting this online application, it is my intent to conduct this transaction with the Georgia Board of Examiners of Licensed Practical Nurses using electronic means and that the submission of the application means that I affirm that the answers to the following questions and statements made on this application are true and correct to the best of my knowledge and belief. I affirm this with the understanding that any omissions, inaccuracies or failure to make full disclosures may be deemed sufficient reason to deny, suspend or revoke a license issued by the Georgia Board of Examiners of Licensed Practical Nurses. <\/p>\n

I further state that I have read the current state laws and board rules and regulations of the Georgia Board of Examiners of Licensed Practical Nurses governing the practice of nursing in the State of Georgia. I swear or affirm that I understand these laws and rules. I agree to abide by these laws and rules. I also agree to abide by future laws and rules that may be established by the Georgia Board of Examiners of Licensed Practical Nurses. I understand that violation of the laws and rules governing the practice of pharmacy may result in disciplinary action being taken against me which may include denial, suspension or revocation of my license to practice optometry.
\nBy submitting this application, it is my intent to electronically sign this application. <\/p>\n

Question\t<\/p>\n

Answer
\nAre you a U.S. citizen?\t <\/p>\n

Have you ever been arrested, convicted of a felony or misdemeanor (other than minor traffic violation) or entered a plea of guilty, nolo contendere or under the \u201cFirst Offender Act,\u201d or been sanctioned by another board or agency? DUI and DWI are not minor traffic violations.<\/p>\n

If you answered \u201cYes\u201d to the question regarding court convictions, you must submit to the Board the following: a) a copy of conviction\/sentencing document(s) from the Court before which you were convicted and sentenced, signed by the presiding judge, and showing said conviction and sentence; AND, if applicable, b) a statement (on official letterhead) from your probation \/ parole officer regarding your current status\/completion of any probation \/ parole. Your application will not be processed until this information is received and reviewed by the Board.\t <\/p>\n

Have you taken the PN licensing examination in this or any other state? If “Yes,” please submit a list of states and dates of examination to the board.\t <\/p>\n

Has any state licensing board revoked, suspended, refused renewal or otherwise disciplined your license or have you ever voluntarily surrendered your license? If yes, please provide a letter of explanation along with copies of all board orders to the Board office.\t <\/p>\n

Have you failed to renew a license, certification or registration during an investigation against you by a licensing board or other agency?<\/p>\n

Name:\tAddresses:\t<\/p>\n

Licensee Address:<\/p>\n

\tStreet:
\n\tCity:
\nState:\t\tZip Code:\t<\/p>\n

Email:
\nPhone:
\n\tFax:\t<\/p>\n

License Address:<\/p>\n

\tStreet:
\n\tCity:
\n\tState:
\n\tZip Code:
\n\tEmail:
\n\tPhone:
\n\tFax:\t<\/p>\n

License Being Applied For:<\/p>\n

License Number:\tPending\tProfession:\tLicensed Practical Nurse\tLicense Type:\tLicensed Practical Nurse\tLicense Status:\tPending
\nIssued:\t\tExpires:\t\t\t\t\t<\/p>\n

Question Answers Summary<\/p>\n

Are you a U.S. citizen?
\nHave you ever been arrested, convicted of a felony or misdemeanor (other than minor traffic violation) or entered a plea of guilty, nolo contendere or under the \u201cFirst Offender Act,\u201d or been sanctioned by another board or agency? DUI and DWI are not minor traffic violations.<\/p>\n

If you answered \u201cYes\u201d to the question regarding court convictions, you must submit to the Board the following: a) a copy of conviction\/sentencing document(s) from the Court before which you were convicted and sentenced, signed by the presiding judge, and showing said conviction and sentence; AND, if applicable, b) a statement (on official letterhead) from your probation \/ parole officer regarding your current status\/completion of any probation \/ parole. Your application will not be processed until this information is received and reviewed by the Board.
\nHave you taken the PN licensing examination in this or any other state? If “Yes,” please submit a list of states and dates of examination to the board.
\nHas any state licensing board revoked, suspended, refused renewal or otherwise disciplined your license or have you ever voluntarily surrendered your license? If yes, please provide a letter of explanation along with copies of all board orders to the Board office.
\nHave you failed to renew a license, certification or registration during an investigation against you by a licensing board or other agency?\t<\/p>\n

Click here to download and print the LPN Consent Form that must be submitted to the Board in order for your application to be considered. <\/p>\n

“At this point please review the name, address, and license information. Go back to make corrections where required. If you are not a U.S. citizen but are a qualified alien under the federal Immigration and Naturalization Act, and are lawfully present in the United States, submit the form found here<\/a><\/strong> to the Board. When satisfied with your submissions, click the “Pay Fees and Submit” link below to submit your application. Application fees are nonrefundable.”<\/p>\n

DOCUMENTATION TO DETERMINE QUALIFIED ALIEN STATUS
\nPlease check the box which applies to your status. You must provide copies of the required documentation as an attachment to this form.
\nAlien Lawfully Admitted for Permanent Residence:
\n_____ – USCIS Form I-551 (Alien Registration Receipt Card, commonly known as a \u201cgreen card\u201d
\n_____ – Unexpired Temporary I-551 stamp in foreign passport or on USCIS Form I-94
\nAsylee:
\n_____ – USCIS Form I-94 annotated with stamp showing admission under \u00a7208 of the INA
\n_____ – USCIS Form I-688B (Employment Authorization Card) annotated \u201c27a.12(a) (5)\u201d
\n_____ – USCIS Form I-766 (Employment Authorization Document) annotated \u201cA5\u201d
\n_____ – Grant letter from the asylum office of USCIS
\n_____ – Order of an immigration judge granting asylum
\nRefugee:
\n_____ – USCIS Form I-94 annotated with stamp showing admission under \u00a7207 of the INA
\n_____ – USCIS Form I-688B (Employment Authorization Card) annotated \u201c274a.12 (a) (3)
\n_____ – USCIS Form I-766 (Employment Authorization Document) annotated \u201cA3\u201d
\n_____ – USCIS Form I-571 (Refugee Travel Document)
\nAlien Paroled Into the U.S. for at Least One Year:
\n_____ – USCIS Form I-94 with stamp showing admission for at least one year under \u00a7212(d) (5) of the INA
\nAlien Whose Deportation or Removal Was Withheld:
\n_____ – USCIS Form I-688B (Employment Authorization Card) annotated \u201c274a.12 (a) (10)
\n_____ – USCIS Form I-766 (Employment Authorization Document) annotated \u201cA10\u201d
\n_____ – Order from an immigration judge showing deportation withheld under \u00a7241 (b) (3) of the INA
\nAlien Granted Conditional Entry:
\n____ – USCIS Form I-94 with stamp showing admission under \u00a7203 (a) (7) of the INA
\n_____ – USCIS Form I-688B (Employment Authorization Card) annotated \u201c274a.12 (1) (3)
\n_____ – USCIS Form I-766 (Employment Authorization Document) annotated \u201cA3\u201d
\n_____ – SEVIS Form I-20 validated by the student\u2019s school for work at a particular employer for
\nCurriculum Practical Training
\n_____ – SEVIS Form I-20 validated by the student\u2019s school for work at a particular employer
\nPlus a valid Employment Authorization Card noted for OPT-Optional Practical Training
\nCuban\/Haitian Entrant:
\n_____ – USCIS Form I-551 (Alien Registration Receipt Card, commonly known as a \u201cgreen card\u201d) with the code CU6, CU7, or CH6
\n_____ – Unexpired temporary I-551 stamp in foreign passport or on USCIS Form I-94 with the code CU6 or CU7
\n_____ – USCIS Form I-94 with stamp showing parole as \u201cCuba\/Haitian Entrant\u201d under \u00a7212(d) (5) of the INA
\nAlien Who Has Been Battered or Subjected to Extreme Cruelty:
\n_____ – USCIS petition and appropriate supporting documentation
\n___________________________________
\nName of Applicant (please print clearly)
\n_____________________________________________________________________
\nSignature of Applicant Date Signed (MM\/DD\/YYYY <\/p><\/blockquote>\n

HERE<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

If you apply for a professional license – in this case a nursing license – on the Georgia Secretary of State’s Website, you will see this online application. “By submitting this online application, it is my intent to conduct this transaction with the Georgia Board of Examiners of Licensed Practical Nurses using electronic means and […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/www.thedustininmansociety.org\/blog\/wp-json\/wp\/v2\/posts\/4324"}],"collection":[{"href":"https:\/\/www.thedustininmansociety.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.thedustininmansociety.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.thedustininmansociety.org\/blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.thedustininmansociety.org\/blog\/wp-json\/wp\/v2\/comments?post=4324"}],"version-history":[{"count":0,"href":"https:\/\/www.thedustininmansociety.org\/blog\/wp-json\/wp\/v2\/posts\/4324\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.thedustininmansociety.org\/blog\/wp-json\/wp\/v2\/media?parent=4324"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.thedustininmansociety.org\/blog\/wp-json\/wp\/v2\/categories?post=4324"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.thedustininmansociety.org\/blog\/wp-json\/wp\/v2\/tags?post=4324"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}