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gov VERIFICATION OF LICENSURE AND EXAMINATION OF AN ARCHITECT Applicants should complete only Section I of this form. Forward this form to the appropriate state registration board to be completed and returned to the Nebraska Board. This form can be found online at http://www.ea.ne.gov/verification.html FROM (STATE BOARD NAME): DATE: ADDRESS: FILE NO.: SECTION I: APPLICANT INFORMATION NAME DATE OF BIRTH: LAST 4 DIGITS OF SSN: ADDRESS (STREET, CITY, STATE, ZIP) Reset Form SECTION II: VE.

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