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Ct. gov/drs Certificate of Authority for Out of State Corporations Connecticut Secretary of the State 30 Trinity Street Hartford CT 06106 860 509-6200 or www. sots. state. ct. us FOR OFFICIAL USE ONLY STATE OF CONNECTICUT DEPARTMENT OF CONSUMER PROTECTION HMCA -01 REV 09/09 APPLICATION FOR HOMEMAKER COMPANION AGENCY Sec. I Applicant Information Please type or print Name of Individual Partnership Corporation LLC or LLP Reference Sections 52-62 of .

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How to fill out the Online Homemakercompanion Forms online

Filling out the Online Homemakercompanion Forms is a critical step for individuals and organizations looking to become registered Homemaker Companion agencies. This guide provides a detailed, step-by-step approach to assist users in completing the forms accurately and efficiently.

Follow the steps to successfully complete and submit the form.

  1. Click ‘Get Form’ button to retrieve the form and open it in the editing interface.
  2. Begin with Section I, where you need to provide your applicant information. This includes the name of the individual, partnership, corporation, LLC, or LLP, as well as the trade name, address, contact phone number, and email (optional). Make sure to include your Federal Employer ID and State Tax Number. If your business and residence addresses differ, complete both addresses.
  3. Proceed to Section II, Organizational Structure. Here, check the appropriate box to indicate your business type: Sole Proprietorship, Partnership, Limited Liability Company, Limited Liability Partnership, or Corporation. Provide the number of Homemaker companions and employees accordingly.
  4. In Section III, Personal Information, list all individuals associated with the ownership of the applicant business. This may include sole proprietors, corporate officers, partners, and LLC or LLP members. Include relevant personal details such as residence address, phone number, date of birth, and social security number.
  5. Move on to Section IV, Relevant Information. Answer all questions thoroughly, especially concerning any previous licenses, judgments, or felony convictions. Attach any necessary explanatory statements or documentation if applicable.
  6. In Section V, ensure that at least one applicant's signature is notarized. This section certifies that the information provided is accurate and complete to the best of the applicant's knowledge. Include the date, printed name, and notary details.
  7. Once completed, review your application thoroughly for accuracy. You are required to submit a payment of $375.00, made payable to the 'Treasurer, State of Connecticut.' Prepare your application for submission.
  8. Finally, save your changes, download or print the completed form, and share it as required. Be sure to mail the application and payment to the appropriate department.

Complete your homemaker companion registration application online today and ensure compliance with state regulations.

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Homemaker Caregivers help elders maintain a safe and clean home. Performing various housekeeping tasks, meal preparation and companionship activities for clients in their homes.

The most basic difference between the two is that a homemaker companion offers companionship and is responsible for casual supportive tasks and providing company, whereas a home health aide can also offer hands-on personal care, including activities of daily living, where physically touching the client is required.

A Definition of Companion Care Light housekeeping. Other household chores such as washing clothing and dishes. Running errands such as grocery shopping. Planning and scheduling appointments and social activities. Transportation to appointments and other activities. Preparing meals. Socialization and entertainment.

A companion has less or no training than a personal aide/caregiver and are best for people that need “non-medical” help with some or many aspects of daily living. A companion can prepare meals, do light housekeeping, and offers companionship.

Homemaker & Companion Services Providers employ individuals to do housekeeping, cook, run errands, and provide companionship to the elderly and adults with disabilities. They cannot provide any personal care or nursing ing to state law.

A homemaker/companion provides for the maintenance of a safe and clean environment. Performs various housekeeping tasks, meal preparation and companionship activities for clients in their residences.

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