Get Sc Dhec 0217 2019-2025

The SC DHEC 0217 form is essential for individuals and entities seeking to apply for a license to operate a community residential care facility in South Carolina. This guide will walk you through the process of completing the form online, ensuring that you provide all necessary information accurately and clearly.

Follow the steps to complete the SC DHEC 0217 online.

1. Begin by clicking the 'Get Form' button to access the SC DHEC 0217 form and open it within the online editor.
2. Indicate the reason for your application by checking the appropriate box: initial, renewal, or amended license request. Be sure to provide any required details, such as license number and expiration date if renewing.
3. In Part A, enter the facility information, including the facility name, physical address, and contact details. If applicable, ensure to provide the certified food protection manager's information and attach a copy of their certification.
4. Complete Part B with the operation and ownership disclosure. Provide the licensee information and select the type of ownership from the options available, making sure to attach any required documents.
5. If you are requesting any changes, fill out Part C accordingly. Specify if you are changing the facility name, address, or ownership, and include the necessary prior and new details.
6. Sign and have Part D notarized, ensuring to include the necessary signatures from the appropriate individuals as outlined. Ensure compliance with the criminal records check requirement.
7. Once all sections are complete, review the form for accuracy. Save changes, download a copy, print the form, or share it as needed.

Complete your SC DHEC 0217 form online today to ensure a smooth application process.