Free Lic 309 Form in PDF

Instructions on Writing Lic 309

Completing the LIC 309 form is a straightforward process that requires attention to detail and accuracy. This form is essential for corporations and limited liability companies involved in the health and human services sector in California, needing to report changes in their organizational structure. The following steps outline how to fill out the form correctly. Upon completion, ensure all necessary documentation is attached before submission to the Licensing Agency to ensure compliance with California regulations.

1. Start with the facility information at the top of the form. Fill in the date, facility name, facility address, and facility number.
2. Under Corporation/Limited Liability Company (LLC), enter the name of the corporation or LLC as it is filed with the Secretary of State.
3. Provide the name of the Chief Executive Officer.
4. Fill in the incorporation or registration date and the place of incorporation or registration, along with the corporation/limited liability company number.
5. Attach the required documents: a copy of the Articles of Incorporation or organization and any amendments, a copy of the By-Laws or Operating Agreement and any amendments, and a copy of the Resolution authorizing the filing of this application (for corporations only).
6. Enter the principal office of business address, city, zip code, county, and the contact person's name, title, and telephone number.
7. For out-of-state or foreign applicants, provide the name of the California representative, their address, and telephone number. Also, attach a copy of the foreign corporation’s or LLC’s registration to do business in California.
8. List the names and addresses of all persons who own ten percent or more interest in the corporation or LLC. Use an additional sheet if more space is needed.
9. Under Directors/Managers and Managing Members, specify the number, term of office, frequency of meetings, and method of selection (for corporations).
10. For the Officers section, list the president, vice-president, secretary, and treasurer along with their principal business address (other than facility address) and telephone number. Note the term expiration for each officer.
11. Detail all Directors (for corporations) or Managers and Managing Members (for LLCs) with their names, mailing addresses, and telephone numbers. Include the term expiration and attach additional sheets if necessary.
12. If applicable, complete the Public Agency section by checking the type of public agency, providing agency details, specifying the district or area to be served, and attaching the necessary legal documentation.
13. In the Partnerships section, attach a copy of the partnership agreement and provide information on all partners, including the type (general or limited), name, principal business address, and telephone number.
14. For Other Associations, provide a list of persons legally responsible for the organization, contact information, and appropriate legal documents detailing the organization's legal responsibility and accountability.

After carefully reviewing the form for completeness and accuracy, attach all required documents and submit it to the Licensing Agency. This step is crucial for maintaining compliance with the state's regulatory requirements and ensuring the continuity of operations.

What is the LIC 309 form?

The LIC 309 form is a critical document required by the State of California Health and Human Services Agency, specifically for corporations and limited liability companies (LLCs) that are involved in community care licensing. This form plays a fundamental role in ensuring that the California Department of Social Services Community Care Licensing Division is up-to-date with any changes in partners, officers, or structural adjustments in the corporation or LLC as mandated by the California Code of Regulations. Failure to submit this form timely can lead to non-compliance with state regulations.

When do I need to submit the LIC 309 form?

Any time there is a change in partners, officers, or when significant alterations occur within the corporation or limited liability company, you are required to update and submit the LIC 309 form. These changes must be reported as stipulated in Title 22, Section 80034(a)(2), 87235(a)(5), or 101185(a)(2) of the California Code of Regulations. It’s crucial to keep records current to maintain compliance with state requirements for operating a community care facility.

What information is required on the LIC 309 form?

The form requires detailed information about the corporation or LLC, including the name as filed with the Secretary of State, the Chief Executive Officer, incorporation/registration date, and place of incorporation. It also requires attachments such as a copy of Articles of Incorporation or organization, By-Laws or Operating Agreement, and, for corporations, a Resolution authorizing the filing of this application. Additionally, it collects data on the principal office, California representatives for out-of-state applicants, owners with a significant interest, directors/managers, and officers, ensuring a comprehensive understanding of the entity’s organizational structure.

How do I handle changes in ownership or management reported on the LIC 309 form?

Changes in ownership or management should be reported by filling out a new LIC 309 form with the current information. This includes any change in the persons owning ten percent (10%) or more interest in the corporation or LLC, as well as any changes in directors, managers, managing members, or officers. The updated form ensures that the Community Care Licensing Division has the most recent details about your organization’s administration and ownership.

Who needs to sign the LIC 309 form?

For corporations, a duly authorized officer must sign the LIC 309 form, typically someone who holds a key position such as the President or Chief Executive Officer. In the case of limited liability companies (LLCs), a managing member or an appointed manager responsible for the LLC's operations should sign the document. The signature certifies that the information provided is accurate and complies with the regulations outlined by the Community Care Licensing Division.

What if my entity is not a corporation or LLC? Do I still use the LIC 309 form?

The LIC 309 form is specifically designed for corporations and LLCs. However, the reverse side of the form provides sections for public agencies, partnerships, and other associations. Each type of entity has dedicated sections to fill out relevant information. It’s important to carefully review the instructions and complete the sections that apply to your entity's qualifications for accurate processing by the licensing agency.

Where do I submit the completed LIC 309 form?

The completed LIC 309 form should be submitted directly to the California Department of Social Services Community Care Licensing Division. You can find specific submission instructions and the mailing or physical address for submission by contacting them directly or visiting their website. Ensure to keep a copy of the form for your records and note the date of submission to track your compliance with state regulation requirements.

Completing the LIC 309 form requires attention to detail and an understanding of the specific requirements set forth by the State of California Health and Human Services Agency. However, mistakes can easily be made, which can lead to delays or issues with the licensing process. Here are ten common mistakes people make while filling out the form.

One common error is not updating the form when there are changes in the company’s structure, such as changes in partners or officers. This oversight can lead to discrepancies between the company’s current operational structure and what is reflected in the state’s records, potentially impacting legal and operational standing.

Another mistake involves the incorrect listing of the corporation or LLC name, as it was filed with the Secretary of State. Accuracy in this detail is critical for legal identification and verification processes. Variations or inaccuracies can cause confusion or delay in processing.

Often, applicants forget to attach the required documents such as the Articles of Incorporation, By-Laws, or Operating Agreement and any amendments to these documents. This oversight can render the application incomplete, leading to potential delays in the licensing process.

A significant amount of applicants fail to provide a copy of the resolution authorizing the filing of this application for corporations. This document is key to demonstrating that the application is made with the full consent and authorization of the corporation’s governing body.

Not specifying the principal office of business address correctly is another frequent mistake. This information is essential for contact and administrative purposes, especially for out-of-state or foreign applicants required to have a registered business address in California.

Many also incorrectly handle the section regarding the names and addresses of owners who hold a ten percent or more interest in the corporation or LLC. Omitting this information or failing to provide additional space for listing all relevant individuals compromises compliance with state requirements.

In the sections detailing the corporation or LLC’s directors, managers, and managing members, a common error is omitting the term of office, frequency of meetings, or method of selection (for corporations). Such details are crucial for the state’s understanding of the organization’s governance structure.

For LLCs without traditional officers, skipping the officers' section without proper indication can lead to confusion. It's important to clearly indicate that this section does not apply to avoid any misunderstanding regarding the organizational structure.

When listing all directors, managers, and managing members, another mistake is not attaching an additional sheet when space provided on the form is insufficient. Ensuring that every pertinent individual is listed is fundamental for full disclosure and compliance.

Finally, a common oversight is not attaching the required copy of the partnership agreement or similar legal documents for other types of associations. These documents are essential for verifying the legal basis of the partnership or association’s operation and authority.

Understanding and avoiding these common mistakes can significantly streamline the application process, helping ensure that submissions are complete, accurate, and compliant with the California Department of Social Services' requirements.

When businesses or organizations prepare to submit the LIC 309 form for state licensing, several other forms and documents typically accompany it to ensure full compliance and accurate representation. These ancillary documents are essential for offering a comprehensive overview of the entity's legal, operational, and financial status.

1. Articles of Incorporation or Organization: This is a crucial document for corporations or limited liability companies as it legally establishes the entity within the state. It includes vital information about the business, such as its name, purpose, structure, and capital stock details if applicable. This document heralds the beginning of the corporate existence.
2. Bylaws or Operating Agreement: These documents outline the internal rules governing the management of the corporation or LLC. They include procedures for holding meetings, electing directors or managers, and the rights and responsibilities of the owners. Bylaws apply to corporations, while an operating agreement is used by LLCs, offering a framework for operational and decision-making processes.
3. Resolution Authorizing Filing: For corporations, a board resolution may be required, showing that the board of directors has authorized the submission of the LIC 309 form. This ensures that the corporation acts within its predefined rules and with full board awareness.
4. Foreign Qualification to do Business in California: If the entity is based out-of-state or is a foreign corporation or LLC, registration documents showing approval to do business in California are necessary. This demonstrates compliance with California laws for foreign entities seeking to operate in the state.

Understanding each document's role illuminates the broader context of the licensing process, revealing how these forms collectively establish the entity's legal and operational foundation in the eyes of California's regulatory bodies. The careful preparation and submission of these documents, alongside the LIC 309 form, pave the way for successful licensing and enduring compliance.

The LIC 309 form used for health and human services in California shares similarities with forms like the IRS Form 1023, which is used by non-profit organizations seeking tax-exempt status. Both require detailed organizational information, including incorporation details, principal office addresses, and the names and addresses of key members. Where the LIC 309 form asks for information regarding corporations or LLCs and their operation within the state, Form 1023 requires non-profits to provide a thorough description of their activities, bylaws, and officers to assess eligibility for tax exemption, emphasizing the regulatory requirement for clear organizational structure and purpose documentation.

Another document resembling the LIC 309 is the SEC Form D, often used for filing a notice of an exempt offering of securities in the United States. Both forms mandate the disclosure of significant details about the company, including its executive officers and the structure of its equity. While the LIC 309 targets state-specific regulatory compliance regarding health and human services, SEC Form D focuses on providing transparent investment information to protect investors and comply with federal securities laws, linking them through their foundational need for organizational transparency.

The Uniform Business Report (UBR) filed with state governments for business registration purposes also mirrors the LIC 309 form. Both require information about the business's principal officers and managing members, corporate structure, and registered office address. Although the focus of the UBR is broader, encompassing all types of businesses for general state compliance, the essence of providing comprehensive organizational details aligns closely with the LIC 309's objective of updating and documenting changes in corporate or LLC structure specifically for licensing purposes in health and human services.

Forms like the Application for Employer Identification Number (EIN), specifically the IRS Form SS-4, share commonalities with the LIC 309 in terms of the necessity to identify the responsible parties and detailed organizational information. The SS-4 form is essential for businesses to obtain an EIN used for tax purposes, requiring information on the entity's officers and their identifiers. This parallels the LIC 309’s requirement for health and human services licensing, where accurate and current information on organizational structure and responsible individuals is crucial for operational legitimacy and compliance.

Finally, the Statement of Information (Form SI-550) required by many states for corporations and LLCs to report periodic information closely resembles the LIC 309 form. This statement demands updates on corporate officers, addresses, and sometimes the company's activities, similar to the LIC 309's requirements for facility management in health and human services. Both forms play a critical role in keeping public records accurate and up-to-date, emphasizing accountability and the smooth operation of entities within their respective scopes—health services and general corporate governance.

When it comes to filling out the LIC 309 form for the State of California - Health and Human Services Agency, particularly for corporations and limited liability companies, there are key do's and don'ts that can guide you through the process smoothly. This form plays a crucial role in maintaining current records with the Licensing Agency, especially after any changes in partners, officers, or the corporation/LLC itself. Here's a concise guide:

• Do ensure that the name of the corporation or limited liability company is exactly as filed with the Secretary of State. This ensures consistency and avoids processing delays.
• Do attach all required documents, including a copy of the Articles of Incorporation or Organization, any amendments, and, if applicable, a copy of the By-Laws or Operating Agreement and any amendments. For corporations, a copy of the Resolution authorizing the filing of this application is also necessary.
• Do provide the complete principal office address, including city, zip code, and county, along with a reliable contact person's title and telephone number. This information is essential for any follow-up or clarification.
• Do not leave out information about out-of-state or foreign applicants. If applicable, include the name and contact information of the California representative and attach a copy of the registration to do business in California.
• Do not forget to list all persons who own ten percent (10%) or more interest in the corporation or LLC. If the standard space is insufficient, attach an additional sheet.
• Do accurately list all Directors (for Corporations) or Managers and Managing Members (for LLCs), including their term of office, frequency of meetings, and the method of selection for corporations. Ensure all contact details are current and correct.

By following these recommendations, the process of completing and submitting the LIC 309 form can be both efficient and error-free. Remember, accuracy and thoroughness are key in legal documents to ensure compliance and facilitate smooth operations within the realm of California's Health and Human Services Agency's requirements.

Many misunderstandings surround the use of the LIC 309 form, a document essential for certain entities operating within California's Health and Human Services Agency framework. Here are ten common misconceptions debunked to provide clarity.

1. The LIC 309 is only for new applicants. This is incorrect. The form must be updated and submitted each time there's a change in partners, officers, or the structure of the corporation or LLC, not just at the time of a new application.

2. Public agencies are exempt from filling out the LIC 309. This misunderstanding overlooks the form's reverse side, specifically designed for public agencies, partnerships, and other associations to fill out relevant details.

3. Updating the form is optional after initial submission. On the contrary, the regulation clearly states that entities must submit updated forms following any significant organizational change, ensuring current information is on file.

4. Foreign corporations don’t need to fill it out. This is a misconception. Foreign corporations and LLCs operating in California are required to attach a copy of their registration to do business in the state, indicating that they too must comply with this requirement.

5. The form doesn’t apply to LLCs without officers. While it's true that the section concerning officers can be skipped by LLCs without them, these entities are still obliged to complete the rest of the form, including providing details on managing members.

6. Filling out the LIC 309 form is a one-time requirement. This notion fails to recognize that any alterations in corporate structure, such as the change of officers or ownership stakes, necessitate a form update.

7. All information is public once submitted. While the form is a public document, sensitive information is handled according to privacy laws and regulations, ensuring a balance between transparency and privacy protection.

8. Electronic submission is available for all sections. As of the last known update, the form requires a manual submission process, including mailing physical documents, especially critical for attachments such as articles of incorporation.

9. Only the primary business needs to submit this form. In truth, any entity under the regulatory scope, including subsidiaries or affiliated businesses meeting certain criteria, must complete and submit the form.

10. Partner information is irrelevant for corporations. This is a misconception, as the form requests information about individuals with significant control or ownership stakes in the entity, which could include partners in various corporate structures.

Clarifying these misconceptions encourages compliance and ensures entities fully understand their obligations under California's regulatory framework, fostering an environment of transparency and accountability within the Health and Human Services sector.

Filling out the LIC 309 form is an essential task for maintaining proper records and compliance with state regulations for corporations, limited liability companies (LLCs), public agencies, partnerships, and other associations operating in California. Understanding the process can ensure accuracy and prevent potential legal issues. Here are key takeaways to guide you through this process:

• Update as Required: The form needs to be updated and submitted to the Licensing Agency each time there is a change in partners, officers, or changes in the corporation or LLC, as specified in the California Code of Regulations.
• Sections for Different Entities: The form is divided into sections; with the front side dedicated to corporations and LLCs and the reverse side to public agencies, partnerships, and other organizations. This ensures the relevant information for each entity type is accurately provided.
• Comprehensive Information Needed: Entities are required to provide detailed information including the official name as filed with the Secretary of State, chief executive officer, incorporation/registration date, and principal office address among others.
• Attachment of Key Documents: Along with the LIC 309 form, entities must attach copies of Articles of Incorporation or organization including any amendments, By-Laws or Operating Agreement and any amendments, and for corporations, a copy of the Resolution authorizing the filing of this application.
• Disclosure of Ownership: Names and addresses of all persons owning ten percent (10%) or more interest in the corporation or LLC must be disclosed. Additional space must be attached if needed.
• Information on Management: Details about directors (for corporations)/managers and managing members (for LLCs), including the number, term of office, frequency of meetings, and method of selection (for corporations), must be provided.
• Public Agency Specifics: For public agencies, there is a requirement to specify the type of agency (e.g., federal, state, county), the agency providing services, geographic area served, and attachment of resolution or legal document authorizing the application.
• Partnerships and Other Associations: Partnerships need to attach a copy of the partnership agreement, and other associations must provide a list of persons legally responsible for the organization, contact person, and appropriate legal documents establishing legal responsibility.

Preparing and submitting the LIC 309 form is a crucial step towards ensuring your entity operates within the legal frameworks set by the California Department of Social Services Community Care Licensing Division. Providing accurate and comprehensive information will help facilitate a smoother review process, ensuring your operations comply with Californian regulations.