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  • Hhs-690 2019

Get Hhs-690 2019-2025

S.W. Washington D.C. 20201 Name of Healthcare Facility Receiving/Requesting Funding Street Address City State Zip Code Form HHS-690 3/2011. ASSURANCE OF COMPLIANCE REHABILITATION ACT OF 1973 TITLE IX OF THE EDUCATION AMENDMENTS OF 1972 AND THE AGE DISCRIMINATION ACT OF 1975 The Applicant provides this assurance in consideration of and for the purpose of obtaining Federal grants loans contracts property discounts or other Federal financial assistance from the U.S. Department of Health and Human Services. THE APPLICANT HEREBY AGREES THAT IT WILL COMPLY WITH 1. Title VI of the Civil Rights Act of 1964 Pub. L* 88-352 as amended and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services 45 C. F*R* Part 80 to the end that in accordance with Title VI of that Act and the Regulation no person in the United States shall on the ground of race color or national origin be excluded from participation in be denied the benefits of or be otherwise subje....

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How to fill out the HHS-690 online

The HHS-690 form, known as the Assurance of Compliance, is essential for individuals or organizations seeking federal financial assistance from the U.S. Department of Health and Human Services. This guide provides a clear and detailed approach to filling out the form online.

Follow the steps to complete the HHS-690 form online.

  1. Press the ‘Get Form’ button to access the HHS-690 and open it for completion.
  2. Begin with the 'Applicant Information' section. Enter the name of the agency requesting funding, ensuring accurate spelling and formatting.
  3. Fill in the 'Address Information' fields, including street address, city, state, and zip code. This information should reflect the official address of the applicant.
  4. In the 'Assurance of Compliance' section, carefully review and acknowledge the various civil rights laws and regulations listed. Ensure you understand each section's implications.
  5. Continue to the 'Certification' area, where the authorized official will sign the document. It is critical that this signature is from a person who has the authority to commit the applicant to the terms outlined in the form.
  6. Enter the date of signing in the 'Date' field next to the signature section.
  7. After you've completed the form, you can save your changes, download a copy for your records, print it, or share the form as necessary.

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FORM HHS 690 - HHS.gov
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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
Help Portal
Legal Resources
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