Get Ca Ds 1891 2011-2026

The CA DS 1891 is a crucial document for applicants and vendors seeking to become vendored providers in California. This guide will help you navigate the online process to accurately complete the Applicant/Vendor Disclosure Statement.

Follow the steps to successfully complete the CA DS 1891 form online.

1. Press the ‘Get Form’ button to access the form digitally and open it in your preferred online editor.
2. Complete Part 1: Identifying Information by providing the name of the applicant or vendor, their agency or organization details, vendor number, service code, business address, and telephone number.
3. In the same section, specify the capacity in which the applicant or vendor operates and provide the National Provider Identifier and Social Security Number or Federal Employer Identification Number as required.
4. Check the appropriate box to indicate the entity type that best describes the structure of your organization.
5. Move to Part 2: Ownership and Control Interests. List the individuals with ownership interests or managing employees along with their relevant details.
6. Identify relationships among the listed individuals who are related by family ties and ensure to include their addresses.
7. Disclose any ownership interests in other applicants or vendors where a person with an ownership interest also holds controlling interests.
8. Proceed to Part 3: Excluded Individuals or Entities, detailing any individuals excluded under the specified definitions.
9. If applicable, complete Part 4: Subcontractor Information, listing any subcontractors or wholly owned suppliers associated with significant business transactions.
10. Finally, sign and date the application in the designated section, certifying the accuracy of the information provided.
11. Once the form is completed, you can save your changes, download a copy for your records, print, or share the form as needed.

Start filling out the CA DS 1891 online today to ensure your application is processed efficiently.