Dc 1513 form ownership statement-2026

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  1. Click ‘Get Form’ to open the DC 1513 form in the editor.
  2. Begin by filling out the Identifying Information section. Specify the entity's name, DBA, address, provider number, and contact details.
  3. Proceed to Item II and answer the questions by checking 'Yes' or 'No'. If any are answered 'Yes', provide additional details in the Remarks section on page 2.
  4. In Item III, list all individuals and organizations with a direct or indirect ownership interest of 5% or more. Ensure you include their names and addresses.
  5. For Items IV-VII, indicate any changes in ownership or management within the last year. Provide dates and relevant details as necessary.
  6. Finally, review all entries for accuracy before signing at the bottom of page 2. Ensure that all required fields are completed.

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