Lic 508 d form 2026

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The document is a form from the California Department of Social Services, specifically for Foster Family Homes, Small Family Homes, and Certified Family Homes. It requires individuals to disclose any out-of-state residency within the last five years and any criminal convictions, including those from other states or federal courts. The form emphasizes the importance of honesty in disclosing criminal history, as failure to do so may result in denial or revocation of licenses. It also includes instructions for respondents and licensing agencies regarding the handling of disclosed information.

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Click ‘Get Form’ to open the lic 508 d form in the editor.
Begin with the OUT-OF-STATE DISCLOSURE section. Indicate if you have lived in another state within the last five years by selecting 'YES' or 'NO'. If 'YES', list each state and prepare to complete an LIC 198B for each.
Proceed to the CRIMINAL RECORD STATEMENT section. Answer whether you have ever been convicted of a crime in California or elsewhere by selecting 'YES' or 'NO'. If applicable, provide details on the back of the page.
Fill in your personal information, including your name, address, social security number, and driver's license number. Ensure all entries are clear and accurate.
Sign and date the form at the bottom of page 2 to certify that your responses are true and correct.

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Versions	Form popularity	Fillable & printable
2011	4.8 Satisfied (261 Votes)
2007	4.3 Satisfied (308 Votes)

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out of state disclosure form

Lic 508 d form pdf How to fill out lic 508 d form Lic 508 d form download Lic 508 d form 2021 LIC 508 criminal record STATEMENT PDF LIC 508 no longer required LIC 508 (7 15) LIC 508 O-O-S

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