Get To Operate A Personal Services Agency

Filling out the TO OPERATE A PERSONAL SERVICES AGENCY form is essential for maintaining compliance with licensing requirements. This guide provides a clear step-by-step approach to assist users in completing the form accurately and efficiently.

Follow the steps to successfully complete the form.

1. Press the 'Get Form' button to access the form and open it in your preferred online application.
2. Read through the instructions carefully before starting. Ensure you complete all sections in either printed or typed form. Incomplete or unclear applications may be returned.
3. In SECTION I, enter the name of the agency as it appears on the Indiana Secretary of State document. Include the street address, city, county, and specific contact information such as telephone number, fax number, email address, and ZIP code.
4. Proceed to SECTION II to list the names of the managers. If there have been staffing changes, attach a current criminal history report for each manager.
5. In SECTION III, if applicable, list previously approved branches by providing their names, complete addresses, counties, and telephone numbers. Do not include branch changes in this section.
6. Complete SECTION IV by providing the ownership information. List the legal entity name and EIN number. If there have been changes in ownership, indicate 'Yes' or 'No' and provide necessary details accordingly.
7. In SECTION V, you must certify that your agency's operational policies comply with non-discrimination laws. Also, ensure that you include the printed name and signature of an owner or manager, along with the dates.
8. After completing all sections, review your application for accuracy. You may save changes, download, print, or share your form as needed.

Complete your renewal application online to ensure your agency remains compliant with licensing requirements.