TX HHS Form 3921. Multiple-Certificate Annual Renewal

The TX HHS Form 3921, Multiple-Certificate Annual Renewal, is a crucial document for individuals who hold multiple certifications or licenses related to the deaf and hard of hearing services. This form helps solve the problem of maintaining certification levels by providing an annual renewal process.

This form requires certificate holders to provide essential information, including their name, birth date, BEI certification number, and certification levels. Additionally, it asks about any criminal convictions or disciplinary actions taken against them. The form also includes a section for contact information and payment instructions for the applicable fee.

The Multiple-Certificate Annual Renewal Form 3921 should be used by individuals who need to renew their certifications or licenses annually. It is essential to allow 30 days for processing, as stated in the form. Failure to comply with this timeframe may result in additional fees or penalties. The form can be submitted via mail to HHS DHHS at P.O. Box 12306 Austin, TX 78711, along with the required fee.