Florida birth certificate replacement
[DOCX File]ASSISTED LIVING FACILITIES - Florida
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APPLICATION CHECKLIST. ASSISTED LIVING FACILITIES. The Agency for Health Care Administration (AHCA) has implemented the . ONLINE LICENSING . SYSTEM. which. allows the electronic submission of renewal and change during licensure period applications and fees, along with the ability to upload supporting documentation.
[DOCX File]Florida
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A copy of the health care practitioner(s) license(s) with the Florida Department of Health. Documentation demonstrating the relationship between the licensed practitioner owner and the family member(s) owner [i.e. copy of birth certificate, marriage certificate], if applicable. Documentation confirming the ownership of the entity.
[DOC File]Exhibit 5-3: Acceptable Forms of Verification
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Birth Certificate. Baptismal Certificate. Military Discharge papers. Valid passport. Census document showing age. Naturalization certificate. Social Security Administration Benefits printout Alimony or child support. Copy of separation or divorce agreement provided by ex-spouse or court indicating type of support, amount, and payment schedule.
[DOCX File]Florida
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☐ Each change during licensure period that requires issuance of a new certificate is assessed a $25.00 fee ☐ Other amounts due (fines, assessment, fees, etc.) will be detailed in the application The Agency for Health Care Administration scans all documents for electronic storage.
2A-2
b. Marriage certificate, c. Birth certificate, d. Copy of approval for Social Security Administration survivor benefits, or. e. When the applicant can provide actual documentation that joint expenses exceed the applicant’s income and that the expenses had been paid by the deceased.
[DOCX File]Florida
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Under the authority of Chapters 408, Part II and 383, Florida Statutes (F.S.) and Chapters 59A-35 and 59A-11, Florida Administrative Code (F.A.C.), an application is hereby made to operate a birth center as indicated below: 1. Provider / Licensee Information
[DOCX File]MULTIPHASIC HEALTH TESTING CENTER - Florida
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Replacement License Certificate. No Fee Required: Mailing Address Only Change. Management Company Change . Personnel Change . Type of Test(s) Provided. Hours of Operations. Transfer or assignment of less than 51% of the ownership, shares, membership or controlling interest of the. licensee
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