Get Delta Dental And Practice Sale Form

Completing the Delta Dental And Practice Sale Form is an important step in facilitating the transfer of a dental practice. This guide provides a clear and structured approach to help users fill out the form correctly and efficiently online.

Follow the steps to complete the form successfully.

1. Press the ‘Get Form’ button to access the Delta Dental And Practice Sale Form online.
2. Begin by entering the seller's name in the designated field. Ensure that the name is typed accurately, as it should match official records.
3. Fill in the seller's license number. This should be the official dental license number assigned to the seller.
4. Provide the name of the practice in the specified field. Make sure this name is exactly as it appears on official documents.
5. Enter the seller's Social Security number in the appropriate field. This is essential for identification and tax reporting purposes.
6. Complete the address of the practice including the street, city, state, and ZIP code. Accuracy in this information is crucial for correspondence.
7. Input the Tax Identification Number (TIN) in the indicated field as it is necessary for financial records.
8. If there are additional sellers involved in the practice sale, replicate the above steps for each seller, and ensure each one provides their dated signature.
9. Provide the purchaser's name and license number in the corresponding fields. Ensure accuracy as this information verifies the buyer’s credentials.
10. The purchaser must also enter their Social Security number and TIN in the designated areas.
11. Both the seller and purchaser need to sign and date the form where indicated to validate the transaction.
12. The form also includes sections that require both the seller and purchaser to initial their understanding regarding payments post-sale. Ensure to read these statements carefully before initialing.
13. If applicable, complete the assignment of payments section, ensuring both parties sign and date this area as well.
14. Once all sections are filled out accurately, save the changes, and download the form. You may also choose to print or share the completed document as needed.

Complete your Delta Dental And Practice Sale Form online today to ensure a smooth practice transition.