Get Opwdd Form 159 (1/2/2014)

The OPWDD Form 159 is essential for submitting a request for a Statewide Central Register Database Check. Completing this form accurately online ensures a smooth process for background checks on applicants. This guide provides step-by-step instructions to assist in filling out the form properly.

Follow the steps to complete the OPWDD Form 159 online.

1. Press the ‘Get Form’ button to access the fillable version of OPWDD Form 159 online. This will enable you to enter all required information digitally.
2. In the Registered Provider/Agency Area, type in the full name of the Registered Provider without using abbreviations. If applicable, provide the agency name along with the complete street address, including city, state, and ZIP code.
3. Fill out the Registered Provider/Agency Information section. Include the Authorized Person’s Name, their phone number (with area code), and their email address. Ensure that this person's information is accurate for communication purposes.
4. In the Applicant Information section, list the Applicant's name first, followed by any maiden names or aliases. For all household members, include their names, relationships to the applicant, gender, and date of birth. Use proper formatting: last name first, then first name, and middle name, as needed.
5. Provide complete addresses for the applicant over the last 28 years. Include the street name, city, state, ZIP code, and any apartment numbers. If there are additional addresses, use the supplemental pages (OPWDD Form 159a) for listing.
6. In the Signature Area, ensure that the applicant signs both boxes marked ‘Applicant’s Signature’ with the exact names as recorded in the Applicant/Household Member Area. All signatures must be dated appropriately.
7. If the form is thoroughly filled, you may proceed to save your changes, download the completed form, print it for records, or share it as necessary.

Complete your OPWDD Form 159 online today to streamline the background check process.