Get Hrds Hfs 953 B Disclosure Statement

Filling out the HRDS HFS 953 B Disclosure Statement online is a straightforward process that requires careful attention to detail. This guide aims to provide clear and structured steps to assist you in completing the form accurately and efficiently.

Follow the steps to complete the HRDS HFS 953 B Disclosure Statement.

1. Click 'Get Form' button to obtain the form and open it in your digital editor.
2. Begin by providing basic facility identification details in Section 1. This includes the facility ID number, name, and the type of review being submitted, such as Initial License or Renewal License.
3. In Section 2, list the owner(s) or lessor(s) of the building, land, and equipment. Include their name, address details, and contact numbers. If applicable, check the box for the type of government entity.
4. Proceed to Section 3 to fill in the lessee information. If the facility is leased, confirm by selecting 'Yes' and complete the lessee details. Attach any necessary forms as indicated.
5. In Section 4, indicate whether there is a contracted manager or supervisor. If 'Yes', provide their information and check the government entity type, if applicable.
6. Complete Section 5 by submitting a copy of the Affirmation Attachment (ODH Form 953-D) for individuals who hold an interest in the facility.
7. Finally, in Section 6, note any changes that have occurred regarding ownership, leasing, or management and provide effective dates for these changes.
8. Once all sections are completed, review your entries for accuracy. You can then save your changes, download, print, or share the completed form as needed.

Start filling out your documents online today for an efficient process.