Get Disclosure Of Ownership And Control Interest Statement. Cdph 276 D

Filling out the Disclosure Of Ownership And Control Interest Statement, CDPH 276 D, is an important step for ensuring transparency in ownership and control of training programs. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently online.

Follow the steps to complete your form online with ease.

1. Press the ‘Get Form’ button to obtain the Disclosure Of Ownership And Control Interest Statement. CDPH 276 D and open it in your preferred online editor.
2. In the Identifying Information section, provide the name of your school, any Doing Business As (DBA) name, complete address, and relevant training number. Ensure that the telephone number, city, county, state, and zip code are also accurately filled out.
3. Proceed to section II. Answer the questions by checking 'Yes' or 'No'. If any answers are 'Yes', list the names, addresses, and telephone numbers of individuals or corporations related to your response.
4. In section III, list all individuals and organizations that have a direct or indirect ownership or controlling interest of five percent or more in the school. Include addresses and telephone numbers for each entry as required.
5. If your school is structured as a corporation, provide the names and addresses of directors along with their Employer Identification Number in the remarks section.
6. Continue with the questions regarding any changes in ownership or control within the last two years. Respond to each question by checking 'Yes' or 'No' and provide the necessary dates if applicable.
7. Complete the management and personnel details by listing names, addresses, and training numbers of all affiliated schools and clinical sites used by your school.
8. Finally, type or print the name of the authorized representative, their title, and ensure the signature and date are completed accurately.
9. Once you have completed all sections, review the form for accuracy. You can then save any changes made, download, print, or share the filled-out form as needed.

Complete your Disclosure Of Ownership And Control Interest Statement online today to ensure compliance and transparency.