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NOTIFICATION OF INCOMPLETE APPLICATION

SECTION A LICENSING FORMS for Facility License (LIC 200 or LIC 200A) Information (LIC 215)For: _____ of Administrative Responsibility (LIC 308) Organization (LIC 309) Regarding Client/Resident Cash Resources(LIC 400) Monthly Operating Budget (LIC 401) Bond (LIC 402) Statement (LIC 403) Information Release and Verification (LIC 404) A10. Budget Information (LIC 420) A11. Personnel Report (LIC 500) A12. Personnel Record (LIC 501) A13. Health Screening Report Facility Personnel (LIC 503)For: _____ A14.

SECTION A — LICENSING FORMS A1. Application for Facility License (LIC 200 or LIC 200A) A2. Applicant Information (LIC 215) For: _____ A3. Designation of Administrative Responsibility (LIC 308)

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