Get Pa Hs 633 2016-2026

The PA HS 633 form is essential for individuals or organizations applying for a Certificate of Compliance in Pennsylvania. This guide provides a clear and structured approach to completing the application online, ensuring that every component is properly filled out.

Follow the steps to successfully complete your PA HS 633 application.

1. Press the ‘Get Form’ button to access the form online and open it for editing.
2. Begin by filling out the purpose of application section. Indicate whether you are applying for a new facility or renewing an existing certificate, and provide the certificate number if applicable.
3. In the identification section, enter the name and address of the agency or facility. Include the email address and phone number if available.
4. Next, provide the name and address of the legal entity responsible for the operation, along with their email and phone number.
5. Indicate the county and municipality where the agency or facility is located. Include all relevant information.
6. Fill in the responsible person's details, including their full name and title. This is the individual in charge of daily operations.
7. Specify the type of agency or facility service by selecting the most accurate description from the options provided.
8. If applicable, enter the requested or licensed capacity for personal care homes or assisted living facilities.
9. Provide either the federal employer identification number or the social security number of the legal entity. Remember, disclosure of a social security number is voluntary.
10. Select whether the legal entity operates for profit or non-profit purposes, and provide necessary documentation if required.
11. Answer the inquiries regarding prior license status and criminal history, ensuring that any 'yes' answers are explained on a separate sheet.
12. Attach the relevant documents if this is an initial application, including the certificate of occupancy, articles of incorporation, and fictitious name approval, if applicable.
13. Complete the declaration section by signing and dating the application. Ensure that the individual signing is authorized and provides their printed name and title.
14. Once all fields are completed, save your changes. You can download, print, or share your filled-out form as needed.

Complete your PA HS 633 application online today for a smoother process!