Bcal 569 c 2026

1. Click ‘Get Form’ to open the bcal 569 c in the editor.
2. Begin with Section I – Facility Information. Fill in the Facility Name, Application Type, and Street Address. Ensure you provide accurate details for County, Telephone Number, and Fax Number.
3. In Section II – Applicant/Licensee Information, enter the Corporate or LLC name along with contact details. If your mailing address differs, include that as well.
4. Proceed to Section III for Responsible Agency Information if applicable. Provide the agency name and contact person’s details.
5. Complete Section IV by entering the Licensee Designee and Administrator's information, including their names and Social Security Numbers.
6. In Section VI – Financial Information, answer all questions truthfully regarding financial history. Attach explanations for any 'YES' responses.
7. Finally, review Section VII for Certification and Signatures. Ensure a member of the licensee company signs and dates the form before submission.

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