Get Form 3698

Filling out Form 3698, the resident fund surety bond, is a crucial step for entities providing nursing facility services in Texas. This guide will walk you through each section of the form to ensure you complete it accurately and efficiently.

Follow the steps to fill out the Form 3698 online:

1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
2. In the first section, enter the bond number, county of issuance, and effective date of the bond. Ensure that these details correspond with your records.
3. Next, provide the legal entity's name, facility name, vendor number, street address, city, state, and ZIP code in the designated fields.
4. Then, identify the principal by including the name of the legal entity providing Medicaid nursing facility services.
5. After that, enter the name of the surety company, along with the state of incorporation and the fact that it is licensed to operate in Texas.
6. Proceed to complete the obligations section using the guidelines provided, ensuring you understand each requirement for the management of resident funds.
7. Fill in the penal sum amount, ensuring it reflects the maximum dollar amount of all resident funds to be accepted and managed as described in the form.
8. Complete Schedule A by providing the maximum dollar amounts of resident funds for both the preceding and following year periods.
9. Finally, review all information entered for accuracy, save the changes, and proceed to download, print, or share the completed form as needed.

Start filling out your Form 3698 online today to ensure compliance with Texas regulations.