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Affidavit of continuous compliance

Affidavit Of Continuous Compliance - Fill Online, Printable 2026

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The document is an Affidavit of Continuous Compliance required for the renewal of a license to operate an x-ray facility. It states that the affiant, who is the owner or authorized representative, confirms ongoing compliance with health and safety regulations set by the Department of Health. The affidavit also acknowledges potential liabilities for any deficiencies found during inspections and releases the regulatory body from legal responsibility regarding the license renewal.

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Click ‘Get Form’ to open the Affidavit Of Continuous Compliance in the editor.
Begin by filling in your name in the first blank space, ensuring it matches your legal identification.
Indicate your marital status (single/married) and provide your residential address in the designated fields.
In the next section, specify the name of your x-ray facility and its business address accurately.
Complete the year for which you are renewing your license to operate (LTO) or certificate of compliance (COC).
Review each statement carefully, confirming that you understand and agree to comply with all licensing requirements.
Sign and date the affidavit at the bottom, ensuring that all information is correct before submission.

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Versions	Form popularity	Fillable & printable
2017	4.2 Satisfied (42 Votes)
2013	4 Satisfied (33 Votes)

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