Get La Scr-1 Lic 2013-2025

The LA SCR-1 LIC is a essential form required for individuals involved with child care or juvenile detention facilities in Louisiana. This guide provides clear instructions on how to complete the form online, ensuring that users can accurately provide the necessary information.

Follow the steps to fill out the LA SCR-1 LIC online effectively.

1. Press the ‘Get Form’ button to access the LA SCR-1 LIC and open it in your preferred document editor.
2. Begin filling out the form by entering the name of the licensed facility. Ensure that you print or type the name clearly.
3. Provide the physical address of the licensed facility, including street address, city, state, and zip code.
4. Enter the license number assigned to the facility.
5. Fill in your name as the individual/applicant. This should be printed or typed.
6. Input your date of birth in the appropriate format.
7. Provide your social security number, ensuring accuracy.
8. If applicable, write your maiden name, previous name, or any other name you have used.
9. Indicate your race, ensuring that you select the option that applies to you.
10. Select your sex by checking the corresponding box.
11. Enter your current street address, including city, state, and zip code.
12. If applicable, fill in your most recent previous address, including city, state, and zip code.
13. Provide your current home phone number, current cell phone number, and work phone number.
14. Indicate whether your name is recorded as a perpetrator on the State Central Registry by selecting 'My name is' or 'My name is not'.
15. Confirm if you have or have not been determined to have a justified finding of abuse or neglect since the Risk Evaluation Panel finding.
16. At the end of the form, provide your signature and the date to affirm that the information is true and complete.
17. Ensure that a representative from the licensed facility also signs and dates the form.
18. Finally, save your changes, download, print, or share the completed form as necessary.

Complete your LA SCR-1 LIC online today to ensure compliance with Louisiana regulations.