Self certification form 2026

1. Click ‘Get Form’ to open the self certification form in our editor.
2. Begin with PART I by entering your business's legal name, DCA license number (if applicable), and premises address. Ensure all fields are filled accurately.
3. In PART II, check the boxes that apply regarding compliance with laws and regulations. Be thorough in reviewing each statement to ensure you meet the requirements.
4. For PART III, provide detailed information for each employee at your business, including their names, addresses, telephone numbers, start/end dates, and positions.
5. In PART IV, indicate whether your business will engage in industrial laundry delivery services and complete the vehicle information section if applicable.
6. PART V requires you to describe your procedures for maintaining cleanliness and hygiene standards. Take your time to provide comprehensive responses.
7. Finally, in PART VI, certify that all information is true by signing electronically. You can type your name in the signature field if submitting as a PDF.

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