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Disclosure of Ownership and Control Interest Statement. CDPH 276 D

Disclosure of Ownership and Control Interest Statement. CDPH 276 D 2026

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The document is a Disclosure of Ownership and Control Interest Statement from the California Department of Public Health's Licensing and Certification Program. It requires schools to provide identifying information, answer questions regarding ownership interests, management changes, and financial status, and disclose any relevant affiliations or changes in control within specified timeframes. The form aims to ensure transparency and compliance with state regulations for training programs.

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Click ‘Get Form’ to open the Disclosure of Ownership and Control Interest Statement in the editor.
Begin by filling out Section I with your identifying information. Include the name of the school, address, training number, and contact details.
In Section II, answer the questions regarding ownership and control interests by checking 'Yes' or 'No'. If applicable, provide additional details as requested.
Proceed to Section III where you will list individuals or organizations with a controlling interest. Ensure to include names, addresses, and telephone numbers.
Complete Sections IV through VII by answering questions about changes in ownership or management, bankruptcy filings, and listing affiliated schools and clinical sites.
Finally, ensure that all fields are accurately filled out before signing at the bottom of the form. Use our platform’s features to review your entries for completeness.

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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 the disclosure of beneficial ownership?

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 CDPH 932 form?

Q: What is a CDPH 932 form? A: CDPH 932 is the form number that you will find in the bottom left hand corner of the Certified Nurse Assistant Competency Evaluation Approval letter that you receive from the state.

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 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. [

What is a Form 1513 disclosure of ownership?

The CMS 1513 form serves as a critical disclosure document for revealing ownership and control interests in entities participating or seeking to participate in programs under the Department of Health and Human Services, including Medicare and Medicaid.

Disclosure of Ownership and Control Interest Statement. CDPH 276 D 2026

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How to use or fill out Disclosure of Ownership and Control Interest Statement, CDPH 276 D with our platform

Complete this form in 5 minutes or less

Got questions?

How can I eSign my Disclosure of Ownership and Control Interest Statement. CDPH 276 D in Word?

How to complete and sign Disclosure of Ownership and Control Interest Statement. CDPH 276 D online?

What is a document of ownership?

What is the disclosure of beneficial ownership?

What is a CDPH 932 form?

People also ask

What is a disclosure of ownership?

What is an example of a disclosing entity?

What is the concept of ownership and control?

What is a Form 1513 disclosure of ownership?

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Disclosure of Ownership and Control Interest Statement. CDPH 276 D 2026

Here's how it works

How to use or fill out Disclosure of Ownership and Control Interest Statement, CDPH 276 D with our platform

Complete this form in 5 minutes or less

Got questions?

How can I eSign my Disclosure of Ownership and Control Interest Statement. CDPH 276 D in Word?

How to complete and sign Disclosure of Ownership and Control Interest Statement. CDPH 276 D online?

What is a document of ownership?

What is the disclosure of beneficial ownership?

What is a CDPH 932 form?

Related Searches

People also ask

What is a disclosure of ownership?

What is an example of a disclosing entity?

What is the concept of ownership and control?

What is a Form 1513 disclosure of ownership?

Related links

Try more PDF tools