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(County) (Type of Facility) STATEMENT OF ASSURANCE OF COMPLIANCE WITH TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 FOR OTHER AGENCIES, INSTITUTIONS, ORGANIZATIONS OR FACILITIES The hereby agrees (Name.

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How to fill out the Dss 1464 online

Filling out the Dss 1464 form electronically can streamline the process of ensuring compliance with Title VI of the Civil Rights Act. This guide is designed to help users navigate through each section of the form with ease and clarity.

Follow the steps to successfully complete the Dss 1464 online.

  1. Click the ‘Get Form’ button to obtain the form and open it in your preferred editor.
  2. Begin by entering the name of the institution, organization, or facility in the designated field.
  3. Provide the type of facility in the relevant section to ensure clarity about the entity completing the form.
  4. Fill out the street address, city, state, and zip code for both the physical and mailing addresses as required by the form.
  5. Enter the telephone number and facility license number accurately to avoid any processing delays.
  6. Ensure that an authorized official signs the form in the designated signature area and includes the date.
  7. Print the name and title of the authorized official below their signature to complete this section.
  8. Review the entire form for accuracy and completeness before moving forward.
  9. Once satisfied with the form, you can save changes, download, print, or share the completed document as necessary.

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