Get Dda Addendum Application For Current License Form

Filling out the Dda Addendum Application For Current License Form is an essential step for organizations serving individuals with developmental disabilities in Maryland. This guide provides clear, step-by-step instructions to assist users in completing the form effectively and accurately.

Follow the steps to complete your application online.

1. Click ‘Get Form’ button to access the Dda Addendum Application For Current License Form and open it in your preferred editor.
2. Provide general information by filling in the legal agency name and trading name (doing business as). Include the business address, mailing address (if different), city, state, zip code, county, phone number, fax number, executive director's full name, and email address.
3. Complete the site information section. Select the appropriate service model by checking the relevant options such as ALU, CLS, CSLA, and others provided.
4. Enter details regarding the responsible person on the lease or deed, their capacity, site phone number, and county. Also, fill in the site address, including number, street, city, state, and zip code.
5. Identify the contact person for site opening by providing their phone number and email address. Specify the date when the site is ready to be seen and the proposed date of occupancy.
6. If applicable, provide the address of the existing site that is being closed. Fill in the number, street, city, state, and zip code for that location.
7. Review all entries for accuracy. Once you are satisfied with the details, proceed to save your changes, download, print, or share the completed form as needed.

Complete your Dda Addendum Application For Current License Form online today!