Get Proof Of Liquid Assets Verification Form Policy 02 701 Attachment D

Filling out the Proof Of Liquid Assets Verification Form is an essential step for new providers to demonstrate financial stability. This guide will help you navigate each section of the form to ensure accurate and complete submission online.

Follow the steps to fill out the form online seamlessly.

1. Click ‘Get Form’ button to access the document and open it in your designated editor.
2. Begin by entering the name of the bank where the corporate account is held in the designated field.
3. Provide the complete address of the bank, ensuring all details are accurate.
4. Enter the corporate or business name of the provider in the required section.
5. Fill in the address of the provider, including any additional necessary information.
6. Include the Federal Employer ID Number for the provider in the specified field.
7. Input the printed name of the owner of the agency along with the date of completion.
8. The owner must sign the form and indicate their title in the corresponding fields.
9. The bank or financial institution must complete the section confirming the account details, including account name, date opened, account number, balance, and any holds or restrictions.
10. Obtain the necessary signatures from both the owner of the agency and the bank officer or cashier.
11. Ensure the form is notarized, and include the date of notarization in the appropriate field.
12. Once completed, you can save changes, download, print, or share the completed form as needed.

Complete your documents online today!