Get Notification Of Surrender Of Provider Approval

This guide will assist you in completing the Notification Of Surrender Of Provider Approval form online, providing clear and supportive instructions. Understanding how to accurately fill out this form is essential for compliance with the relevant regulations.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to obtain the form and access it in your online editor.
2. Enter the legal name of the Approved Provider in the designated field. Ensure that the information is complete and accurate.
3. Provide the trading name of the Approved Provider, if applicable. This name may differ from the legal name.
4. Input the Provider Approval number in the relevant section. This number is essential for processing your notification.
5. Indicate the intended date for the surrender to take effect. Use the format DD/MM/YYYY to ensure clarity.
6. Clearly state the reasons for surrendering your Provider Approval. This information helps the Regulatory Authority understand your specific situation.
7. List all Service Approvals held by the Approved Provider, including their numbers and names. Ensure this list is as comprehensive as possible.
8. Confirm that you have notified parents of children enrolled at your education and care service(s) about the pending surrender. Attach evidence of this notification.
9. Provide the name and contact details of the individual who will be the point of contact for this application. This person must be authorized to act on behalf of the Provider.
10. Complete the Notifier Declaration section, including the full name and address of the person signing, along with their position/title.
11. If applicable, include a second notifier's details following the same format as above.
12. After completing all sections, review the form for accuracy, ensuring all required supporting documents are attached.
13. Once confirmed, save your changes, download the completed form, and consider printing or sharing it as needed.

Complete your Notification Of Surrender Of Provider Approval form online to ensure compliance with the regulations.