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ANNUAL PERSONAL DISCLOSURE STATEMENT (PDS) FOR INDIVIDUAL BOARD MEMBERS (if Licensee is a Corporation) and SOLE PROPRIETORS/PARTNERS (if Licensee is a Sole Proprietor or Partnership) (Year ) INSTRUCTIONS.

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How to fill out the Personal Disclosure Statement online

This guide provides a step-by-step approach to completing the Personal Disclosure Statement (PDS) online. By following these instructions, you can ensure that your form is filled out accurately and submitted correctly.

Follow the steps to fill out the Personal Disclosure Statement accurately.

  1. Press the 'Get Form' button to access the Personal Disclosure Statement. This will allow you to open the document in your preferred online editor.
  2. Begin by filling out your personal information in block letters. This includes your full name (last name, first name, middle name), any aliases or other names, sex, date of birth (day, month, year), nationality, and tax identification number.
  3. Provide your contact information by entering your complete address, telephone number, mobile number, and email address. Ensure that all contact details are current and accurately presented.
  4. If you have any relatives who work at PAGCOR, please list their names in the designated section.
  5. List any affiliations you have with PAGCOR licensees, specifying the names of any registered companies or partnerships.
  6. Complete the integrity and financial soundness section. Answer the questions honestly, marking 'Yes' or 'No'. If you answer 'Yes' to any question, provide additional details on a separate sheet.
  7. Fill in your professional history, indicating the nature of your business, the companies you have worked for, and your position title for each role held.
  8. Include any requested enclosures, such as a copy of your income tax return or passport, based on your citizenship status.
  9. Finalize your PDS by reviewing all filled information for accuracy. Certify your responses by signing, dating, and ensuring you adhere to confidentiality agreements stated in the declaration section.
  10. After reviewing, you can save your changes, download a copy, print the form, or share it as required.

Take action today by completing your Personal Disclosure Statement online!

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Disclosure is defined as the act of revealing or something that is revealed. An example of disclosure is the announcement of a family secret. An example of a disclosure is the family secret which is told.

I deeply regret what I did but some good has come out of it. I've seen the impact that my conviction has had on my family and I know that I am now better able to deal with any situation I find myself in, in a much more constructive and calm way.

The professional disclosure statement (PDS) is a document that an LPC, LMFT, or registered associate gives to each client that provides information about the licensee/registered associate and their practice. Who must have a PDS? Every applicant for licensure must submit a PDS as part of his or her application.

The following items are often included: Contact info. Your qualifications including training, experience, licensure and certifications. Professional associations that you belong to. Any limitations on your practice such as being under supervision. Services offered. Your theoretical foundation and counseling approach.

I give my consent for treatment as outlined in this Disclosure Statement. I, the client, understand that I am free to terminate the treatment process at any time by giving appropriate notice with respect to the therapeutic relationship established and the cancellation policy mentioned above.

I will keep confidential anything that you say to me, with the following exceptions: a) you direct me to tell someone else, b) I determine that you are a danger to yourself or others, c) I am ordered by a court to disclose information, d) I suspect or am made aware of physical/sexual abuse of minors, persons with ...

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232