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| Form Number: CCRC Renewal Instructions Letter |  | | Title: Annual Statement Filing Instructions | Published: 2011 | | Description: As a licensed Continuing Care Provider (CCRC), our law and regulations require you to file an annual statement and notice of major change in the organization by May 1. Specifically the law found at O.C.G.A. ยง 33-45-5. |
| Form Number: Citizenship Affidavit GID-276-EN | | | Title: Citizenship Affidavit | Published: 2012 | | Description: Effective 1-1-2012, this form is required of persons making application for all licenses, permits, registrations and certifications in order to comply with the Georgia Illegal Immigration Reform And Enforcement Act. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. |
| Form Number: GID-059-EN NOV09 |  | | Title: Continuing Care Provider and Facility Biographical Affidavit | Published: 2011 | | Description: This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us. |
| Form Number: GID-060-EN NOV09 | | | Title: Annual Statement for Continuing Care Provider and Facility | Published: 2011 | | Description: This form is completed annually for the Provider and the Facility. Included are three parts to this form comprising general interrogatories and the statement of financial condition. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us. |
| Form Number: GID-061-EN JAN2012 | | | Title: Application For Certificate Of Authority As A Continuing Care Provider | Published: 2012 | | Description: This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us. Effective 1-1-2012, this form is required of persons making application for all licenses, permits, registrations and certifications in order to comply with the Georgia Illegal Immigration Reform And Enforcement Act. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. |
| Form Number: GID-061-EN NOV09 Instructions | | | Title: Instructions For Application For Certificate Of Authority As A Continuing Care Provider | Published: 2011 | | Description: This document explains the requirements for making Application For Certificate Of Authority As A Continuing Care Provider. |
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