Get Change In Ownership/corporation/facility Name And ... - Trustedpartner

This guide will help you navigate the process of filling out the Change In Ownership/corporation/facility Name And ... - TrustedPartner form online. By following these steps, you can ensure that all necessary information is submitted accurately and on time.

Follow the steps to complete your form effectively.

1. Click the ‘Get Form’ button to access the form and open it in your chosen tool.
2. Begin by filling in the notification date and previous owner's or corporation's name on the form.
3. Enter the new owner's or corporation's name along with the contact name, address, and phone number.
4. If you are notifying a change in ownership or corporation, submit a new completed Statewide Provider Registration Application (Form AWI-VPK-10) along with two signed copies of the Provider Agreement (Form AWI-VPK-20) to the relevant authority.
5. For a facility name/address change, fill in the current name, current address, new name, new address, and effective date.
6. Select the type of new setting from the provided options if applicable and ensure that all relevant documents are included.
7. Complete the accreditation change section if needed, providing details about the new accreditation or noting if no longer accredited.
8. For a change of director or principal, input the old director name, new director name, and hire date.
9. Review all the information carefully to ensure accuracy before submission.
10. Finally, save your changes, and use the options provided to download, print, or share the form as needed.

Complete your document submission online today to ensure compliance and accuracy.