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Nonresident, Out of State Manufacturer/Wholesaler/Repacker Application Requirements and Forms

An initial application must be submitted for each nonresident establishment in order to do business in New York. A completed application (OOSMW501 23 KB) with notarized signature must be submitted with the registration fee of $825, a copy of your home state license and a completed license verification form (00S506 23 KB) from your resident state. Make checks payable to the New York State Education Department. NOTE: Your cancelled check is your receipt.

You must answer all questions and provide all information requested unless otherwise indicated. Failure to complete all required parts of the application will delay its review. Your signature on page 4 must be notarized by a Notary Public. Submit applications directly to the Office of the Professions at the mailing address at the end of the form.

Nonresident Manufacturer/Wholesaler/Repacker INITIAL or Transfer of Ownership Application Forms

Registered establishments must notify the NYS Board of Pharmacy whenever there is a change of location, change of name or change of officers and/or owners. A completed application (OOSMW501) and license verification form must be submitted to the Office of the Professions at the mailing address at the end of the form whenever these changes occur. There is no fee required for a name, location or officer/owner change.

Nonresident Manufacturer/Wholesaler/Repacker Change of LOCATION

Nonresident Manufacturer/Wholesaler/Repacker Change of NAME

Nonresident Manufacturer/Wholesaler/Repacker Change of OFFICERS and/or OWNERS