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How to use or fill out form 624 with our platform
- Click ‘Get Form’ to open it in the editor.
- Begin by filling out Part I for Establishment. Provide the name of the licensee and facility, along with the location details including street, city, and zip code.
- In Part II for Initial License, attach necessary documents such as the Resident Service Contract and a description of procedures for resolving resident grievances.
- For Part III regarding Surety Bonds and Deposits, describe financial guarantees and provisions for insolvency in separate attachments.
- If renewing your license in Part IV, summarize grievance activities from the past year and include the State Fire Marshal inspection report.
- Finally, if making amendments in Part V, ensure you submit any substantial changes to previously reported information along with applicable fees.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2010 | 4.8 Satisfied (140 Votes) |
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