Form application 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin with State Form 8200, ensuring you attach all required documentation. This form is crucial as it initiates your application process.
3. Next, complete State Form 19733, which implements Indiana Code 16-28-2-6. Make sure to review the instructions carefully.
4. Gather and upload documentation proving your entity’s registration with the Indiana Secretary of State.
5. Include IRS documentation (form SS-4) that reflects your entity's details. Ensure this document is directly from the IRS.
6. Prepare your licensure fee payment, which is $200 for the first fifty beds and $10 for each additional bed. This can be done via check or money order.
7. Complete State Form 51996 for asset verification and attach necessary documents.
8. Upload a fully executed Bill of Sale or similar legal document indicating the effective date of ownership change.
9. Fill out State Form 4332 for bed inventory and include a facility floor plan on standard paper size showing room numbers and bed counts.
10. Lastly, compile any agreements/contracts with service providers relevant to your facility operations.

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