Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
Send disclosure of ownership via email, link, or fax. You can also download it, export it or print it out.
How to use or fill out the 1513 form with our platform
Ease of Setup
DocHub User Ratings on G2
Ease of Use
DocHub User Ratings on G2
Click ‘Get Form’ to open the 1513 form in the editor.
Begin by filling out Section I, providing identifying information such as the name of the entity, provider number, and address. Ensure all details are accurate and current.
In Section II, answer the questions by checking 'Yes' or 'No'. If any question is answered 'Yes', provide additional details in the Remarks section on page 2.
Proceed to Section III where you will list names and addresses of individuals or organizations with a direct or indirect ownership interest of 5% or more. Be thorough in your reporting.
For Sections IV to VIII, follow the prompts regarding changes in ownership, management, and bed capacity. Provide dates and relevant information as required.
Once completed, review all sections for accuracy before saving your work. Use our platform's features to easily modify any entries if needed.
Start using our platform today for free to streamline your completion of the 1513 form!
The Companies Act requires companies to maintain a record of their beneficial owners, which must be disclosed to relevant authorities when requested. This transparency ensures compliance with anti-money laundering (AML) and counter-terrorism financing (CTF) regulations.
What is a disclosure of ownership?
It helps ensure providers have not been unfairly barred from providing services under any federal health care program. It also helps ensure that Medicaid providers do not have relationships with individuals or entities that have been excluded or terminated from participating in any federal health care program.
What is a document of ownership?
A deed is a document that transfers property from one owner to another. It describes the property being transferred and names all parties to the transaction. Its signed by all parties and is filed on the official record.
What is an example of a disclosing entity?
Examples of Disclosing entity in a sentence Disclosing entity means a Medicaid provider (other than an individual practitioner or group of practitioners), or a fiscal agent. The Receiving entity hereby acknowledges that the Confidential Information is proprietorship of the Disclosing entity.
What is the concept of ownership and control?
Ownership and control means ownership of at least 51% of the business, including corporate stock if a corporation, and control over the management and day-to-day operations of the business and an interest in the capital, assets, and profits and losses of the business proportionate to percentage of ownership. [
disclosure of ownership and control interest statement form
1513 form template1513 form pdf1513 form online1513 form download1513 form pdf download1513 form sampleCMS 1513 fillable formHow to fill out 1513 form
certification requirements
2006 Publication 600
by L General Cited by 5 Generally, you can deduct the actual state and local gen- eral sales taxes (including compensating use taxes) you paid in 2006 if the tax rate was the same
instructions for completing disclosure of ownership and
This form is to be completed annually. Any substantial delay in completing the form should be reported to the State survey agency. DETAILED INSTRUCTIONS.
This site uses cookies to enhance site navigation and personalize your experience.
By using this site you agree to our use of cookies as described in our Privacy Notice.
You can modify your selections by visiting our Cookie and Advertising Notice.... Read more...Read less
