Get Jc Cbc 1 Ap Designation And Notarized Sworn Statement Cbc Form 7 14 14.doc

This guide provides detailed instructions on filling out the JC CBC 1 AP Designation And Notarized Sworn Statement CBC Form 7 14 14.doc online. Following these steps ensures proper completion and submission of the form.

Follow the steps to successfully complete the form online.

1. Click the ‘Get Form’ button to access the JC CBC 1 AP Designation And Notarized Sworn Statement CBC Form 7 14 14.doc and open it in the appropriate online editor.
2. Begin by filling out the top right corner of the form. Enter the provider name, agency code, address, city, state, zip, telephone number, and fax number as required.
3. Select the appropriate state oversight agency by checking all that apply from the provided options.
4. In Part 1, print clearly the last name, middle initial, and first name of the authorized person, as well as their business email address, business phone number, title, and business address.
5. Read the statement regarding access to the Justice Center CBC system and ensure the authorized person acknowledges understanding by providing their signature and the date.
6. In Part 2, have the Director of the Provider Agency print their name, title, sign, and date the form to approve the designation of the authorized person.
7. Move to Part 3 to allow the authorized person to confirm their role and understanding of their responsibilities. They must sign and date this section.
8. Find the notary acknowledgment section where a notary public will complete their details. Ensure the authorized person is present to have their signature witnessed.
9. Once all sections are completed, review the form for accuracy and completeness before finalizing.
10. Save your changes, and you can download, print, or share the completed form through your preferred method.

Complete your form online today to ensure timely processing of your request.