Verification Letter Request Form

Verification Letter Request Form

Verification Letter Request
Candidate / Diplomate Information
First Name
Middle Name
Last Name
Date of Birth

MonthDayYear
Date
ABR ID (if known)
Address to where letter will be sent
Individual / Company / State Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Requester Information
Name

First NameLast Name
E-mail Address
Phone Number

Area CodePhone Number
Who is requesting the letter?

Self Verification
Does the letter need to include your previous exam results? Note: If you are using the letter for state/licensing purposes, some states require the letter to include your exam results.
Do you need a copy of the letter emailed to you?

Third-Party Verification
Does the letter need to include the candidate's / diplomate's previous exam results? Note: If you are using the letter for state licensing/permit purposes, some states require the letter to include exam results.

Submission Process
- Once your form has been received by the ABR, you will be charged the applicable fee as outlined below:
  - Candidates/Diplomates requesting a self-verification will be charged $30.00.
  - Third-Party requests will be charged $100.00.
- Within 3-5 business days after submission of this request, an invoice will be sent via PayPay to the email address provided.
- The verification letter will not be processed until the fee is paid
- Please allow 3-5 business days for processing, after payment of fee.
For questions or concerns please contact: adminsupport@theabr.org or call
(520) 790-2900
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