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

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  1. Click ‘Get Form’ to open the Disclosure of Ownership and Control Interest Statement in the editor.
  2. Begin by filling out Section I with your identifying information. Include the name of the school, address, training number, and contact details.
  3. In Section II, answer the questions regarding ownership and control interests by checking 'Yes' or 'No'. If applicable, provide additional details as requested.
  4. Proceed to Section III where you will list individuals or organizations with a controlling interest. Ensure to include names, addresses, and telephone numbers.
  5. Complete Sections IV through VII by answering questions about changes in ownership or management, bankruptcy filings, and listing affiliated schools and clinical sites.
  6. 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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