Get Dc-1513 2004-2025
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How to fill out the DC-1513 online
The DC-1513 form is an essential document required for disclosure of ownership and control interest within health regulation programs. Accurately completing this form ensures compliance and facilitates participation in various health-related initiatives. This guide provides step-by-step instructions to help you fill out the DC-1513 online effectively.
Follow the steps to complete the DC-1513 online.
- Click 'Get Form' button to obtain the form and open it in the editor.
- Begin by filling out the identifying information section. This includes specifying the capacity under which the entity is doing business as (DBA), entering the name of the trade or corporation, and providing the street address, provider number, vendor number, telephone number, city, county, state, and zip code.
- In Item II, answer the questions by selecting 'Yes' or 'No'. If you select 'Yes' for any question, provide the names and addresses of individuals or organizations in the Remarks section on page 2, indicating which item number is being continued.
- Item III requires you to list all individuals and organizations with a direct or indirect ownership interest of 5 percent or more. Direct ownership refers to stock possession or equity interest, while indirect ownership involves ownership through another entity.
- In Items IV-VII, address any changes in provider status. If there has been a change in ownership or control within the last year, specify the date. Include additional information for any 'Yes' responses in the Remarks section.
- Complete the final section regarding your facility, indicating if it is operated by a management company or leased. Provide details on any changes to the administration, including names and dates when applicable.
- Once you have filled out all relevant sections, review your information for accuracy and completeness. You may save any changes, download the form, print it, or share the completed document as needed.
Take the next step in compliance by completing the DC-1513 form online today.
If you are unemployed, you can explore options like Medicaid, which is available to low-income individuals in DC. Additionally, the DC Health Benefit Exchange offers programs to help you apply for coverage. Consider gathering all essential documents, including forms like the DC-1513, to streamline your application process.
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