Get Alaska Administrator Designee Form

This guide is designed to assist users in completing the Alaska Administrator Designee Form online. By following these detailed steps, users can ensure that they accurately provide all necessary information while navigating the form with ease.

Follow the steps to successfully complete the form.

1. Click 'Get Form' button to obtain the form and open it in a digital format for editing.
2. Enter the 'Name of Individual' in the designated field. This should include the full legal name of the person applying.
3. Indicate the role this person will fulfill by checking one of the options: Administrator, Resident Manager, or Designee.
4. Provide the 'Name of Assisted Living Home' along with its phone number to identify the location associated with the application.
5. Fill in the 'Date of Birth' using the format MM/DD/YYYY to ensure the information is recorded correctly.
6. If applicable, provide the 'Driver’s License Number' for further identification of the applicant.
7. Complete the 'Physical Address' section, including the street, city, state (AK), and zip code.
8. Include the 'Mailing Address' in the same format to ensure all communication can reach you.
9. List three character references who are not related by blood or marriage. For each reference, provide their name, mailing address, and phone number.
10. Submit two employment references using the same format as for character references, ensuring these individuals also meet the non-related criteria.
11. Include detailed documentation that demonstrates the applicant meets the required qualifications based on the specified criteria for the home size.
12. Attach any required documentation related to the administrator's qualifications, such as a government-issued ID, TB test results, educational certificates, and work experience proof.
13. Finally, attest by signing the application form where indicated, certifying that all information provided is true and accurate. Save your changes, and you will have the option to download, print, or share the completed form.

Complete your documents easily online today!