0402 Florida Statutes regarding level 2 background screening. Signature of Representative Date STATE OF FLORIDA COUNTY OF Sworn to or affirmed and subscribed before me this day of 20 by to me or produced as proof of identification. Print Type or Stamp Commissioned Name of Notary Public Notary Public DOEA Form 235 Affidavit of Compliance Employer Effective April 2012 Form available at http //elderaffairs. BACKGROUND SCREENING Affidavit of Compliance - Employer AUTHORITY This form is required annually of all employers to comply with the attestation requirements set forth in section 435. 05 3 Florida Statutes. The term employer means any person or entity required by law to conduct background screening including but not limited to Area Agencies on Aging Aging Resource Centers Aging and Disability Resource Centers Lead Agencies Long Term Care Ombudsman Program Serving Health Insurance Needs of Elders Program Service Providers Diversion Providers and any other person or entity which hires em....
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How to fill out the Doea Form 235 online
Filling out the Doea Form 235, also known as the Affidavit of Compliance - Employer, is a crucial step for employers to ensure compliance with background screening regulations in Florida. This guide provides comprehensive and user-friendly instructions to help you complete the form online efficiently.
Follow the steps to complete the Doea Form 235 online.
- Press the ‘Get Form’ button to access the form and open it in your preferred editor.
- Enter the name of the employer in the designated field. This should be the full legal name of the organization or individual responsible for hiring.
- Fill in the employer's physical address, including the street address, city, state, and ZIP code. Ensure that the information is accurate, as it will be used for official purposes.
- In the attestation section, the authorized representative should print their name legibly. This individual must have the authority to sign on behalf of the employer.
- The authorized representative must then sign their name in the designated area to affirm compliance under the penalty of perjury.
- Enter the date of signature in the provided space, ensuring that it reflects the date on which the form is completed.
- Complete the notary section by providing the name of the notary public, who will witness the signing. This section will need to be completed in the presence of the notary.
- After all sections are filled, users can save changes, download a copy of the form, print it for records, or share it as needed.
Take action now by completing the Doea Form 235 online to ensure your compliance with state requirements.
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