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I (we) certify that the information on the application is correct to the best of my (our) knowledge. Search term. If there are multiple persons listed in this application with legal proceedings or criminal convictions to declare, provide documentation on a separate attachment. 2740 Clare Avenue, Bremerton, WA 98310 p: (425) 259-1910 f: (425) 744-2375 www.opkc.com . All Service Centers, Adjudication, and Brentwood CDL are by "Appointment Only." Speed up your business’s document workflow by creating the professional online forms and legally-binding electronic signatures. Get everything you need to configure and automate your company’s workflows. If you don't have one of these numbers, leave this area blank. All you need is smooth internet connection and a device to work on. Draw your signature or initials, place it in the corresponding field and save the changes. Select the area you want to sign and click. 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DMV has extended the expiration date for DLs, IDs, vehicle registrations, inspections, ticket payments and ticket adjudication responses expiring Mar 1, 2020 -Mar 31, 2021 until 45 days after the health emergency ends. no person shall be denied employment on the basis of any legally prohibited discrimination including, but not limited to, such factors as race, color, creed, religion, national or ethnic origin, sex, age, or disability. §41- 1823.B, prior to a person being authorized to act in the capacity of a peace officer. Find the extension in the Web Store and push, Click on the link to the {document you want to e-sign and select. Easily find the app in the Play Market and install it for e-signing your blank fillable car title form. For instance, browser extensions make it possible to keep all the tools you need a click away. 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How to make an electronic signature for the Blank Fillable Car Title Form in the online mode, How to make an e-signature for your Blank Fillable Car Title Form in Chrome, How to make an e-signature for putting it on the Blank Fillable Car Title Form in Gmail, How to generate an electronic signature for the Blank Fillable Car Title Form from your smartphone, How to create an e-signature for the Blank Fillable Car Title Form on iOS, How to generate an electronic signature for the Blank Fillable Car Title Form on Android devices, Include the Vehicle Identification Number. The application is a fillable document and may be saved as a file. in massachusetts, nebraska, oregon and vermont, any person who knowingly and with intent to defraud any insurance company or. Development Review _____ _____ Authorized Signature … All the corresponding type of form fields will be automatically named with the text near the form fields (Take the text fields for an example as below).4. 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Are you looking for a one-size-fits-all solution to e-sign blank fillable car title form? I (we) am (are) the owner(s) of the vehicle described on this application and request that a North Carolina Certificate of Title be issued. 621 Woodland Square Loop SE, Lacey, WA 98503, PO Box 47250, Olympia, WA 98504-7250. If you own an iOS device like an iPhone or iPad, easily create electronic signatures for signing a blank fillable car title form in PDF format. If the information on this translated website is unclear, please contact us at 360.902.3900 for help in your language of choice. Select the area where you want to insert your e-signature and then draw it in the popup window. What You Need To Know About Construction Payment in Washington. APPLICATION MUST BE SIGNED IN INK BY EACH OWNER OR AUTHORIZED REPRESENTATIVE OF FIRMS OR CORPORATIONS. Go beyond e-signatures with the airSlate Business Cloud. APPLICATION FOR CERTIFICATION. ’ The answer is simple - use the signNow Chrome extension. This information will help identify whether you are a qualified candidate for the position. Once completed you can sign your fillable form or send for signing. All fillable fields in the document will be recognized and highlighted.2. Building Permit Application Washington County Inspection Request: 503-846-3699 / www.WashCoORACA.com 155 N. 1st Ave, Suite 350, MS 12, Hillsboro, OR 97124 Phone: 503-846-3470 / … Submit this application along with proper evidence of ownership and appropriate valid proof of financial responsibility such as a liability insurance card or policy. application for missouri title and license title within thirty days to avoid penalty dor-108 (08-2019) any false statement in this application is a violation of the law and may be punished by fine or imprisonment or both. signNow has paid close attention to iOS users and developed an application just for them. After it’s signed it’s up to you on how to export your blank fillable car title form: download it to your mobile device, upload it to the cloud or send it to another party via email. approval per Washington County Grading Ordinance, Section 14.12.230. Telephone: (360) 664-1222 Email: transportation@utc.wa.gov . Use this step-by-step instruction to complete the Blank fillable car title form quickly and with perfect precision. Check all that apply. DDOT | 55 M Street, S.E., Suite 400, Washington, DC 20003| 202.673.6813 | ddot.dc.gov version 10.09.18 | Page 1 of 2 LANGUAGE ACCESS: Call/Téléphonez/Llame al/请拨打/Gọi đến số này/번에 전화하세요/ ይደዉሉ 1-866-874-3972. While the requirements for replacing a lost or damaged vehicle title generally remain the same between these two separate application methods, certain differences may still apply. Clearly Print the Name of the Buyer(s) and the Seller(s). Driver's License & ID Forms. The buyer must complete and register the title to sell it. 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Please see Proclamations by the Governor and Supreme Court Orders on the COVID-19 Response page at www.courts.wa.gov for additional information. The whole procedure can take a few seconds. Read all the field labels carefully. The only areas of the form you must fill out are: Plate or TPO — Enter the Washington State license plate number or the Title Purpose Only (TPO) number. The question arises ‘How can I e-sign the blank fillable car title form I received right from my Gmail without any third-party platforms? The signNow extension offers you a selection of features (merging PDFs, including multiple signers, and so on) for a better signing experience. 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Remove Direct Service Staff for a Certified DVIT Program (Domestic Violence Intervention Treatment), Add or Remove a Service for an Existing DVIT Certification (Domestic Violence Intervention Treatment), Self-Assessment and Monitoring Tool (Home and Community Services), Community Instructor Self-Assessment (Home and Community Services), Community Instructor Self-Assessment for Contract Renewal and/or for Newly Established Contracts (Home and Community Services), Case Manager Instructions Following a Hearing Decision, Private Duty Nursing (PDN) Pre-Contract Education Attestation (Home and Community Services), Residential Referral Transition (Developmental Disabilities Administration), Nursing Assistant Training and Testing Reimbursement, Cost of Care Adjustment (COCA) (Developmental Disabilities), Residential Allowance Request / Insufficient Income and Housemate Allowance (Developmental Disabilities Administration), Residential Allowance Request / Start Up Costs (Developmental 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Planned Action Notice Training / Certification (Home and Community Services), Self Employment Monthly Sales and Expense Worksheet, Basic Food Employment and Training (BFET) Participant Reimbursement, Participant Reimbursement with Interpreter Declaration, Financial Communication to Social Services, Exception to Rule and Notice Guardianship Fees and Related Costs (Aging and Long-Term Support Administration and Developmental Disabilities Administration), Voluntary Placement Agreement for Child or Youth with Developmental Disabilities, Vendor Affidavit of Lost, Stolen, or Destroyed Warrant, Petition for Modification - Administrative Order, Authorization for Expenditure (Non-Employee), Washington State Addendum to Box 2 of Part B - Plan Administrator Response, WorkFirst Word Experience (WEX) Agreement, Confidentiality Statement - Tribal Employee, Companion Home Certification Evaluation (Developmental Disabilities Administration), Service Verification / Attendance Record For Alternative 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Contract Monitoring Tool (Home and Community Services), State Civil Penalty Reinvestment Program Grant (SCPRP) Community Residential Services and Supports (CCRSS) Grant Application, Initial Staff and Family Consultation Plan (Developmental Disabilities Administration), Staff and Family Consultation (SFC) 90-Day (Quarterly) Progress Report (Developmental Disabilities Administration), Initial Specialized Habilitation Plan (Developmental Disabilities Administration), Specialized Habilitation 90-Day (Quarterly) Report (Developmental Disabilities Administration), Initial Community Engagement Plan (Developmental Disabilities Administration), Community Engagement 90-Day (Quarterly) Progress Report (Developmental Disabilities Administration), Music Therapy 90-Day (Quarterly) Report (Developmental Disabilities Administration), Equine Therapy 90-Day (Quarterly) Report (Developmental Disabilities Administration), Existing Companion Home (CH) Movers Checklist (Developmental Disabilities 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Vocational Rehabilitation), Pre-ETS (Pre-Employment Transition Services) Peer Mentoring (Division of Vocational Rehabilitation), Pre-ETS (Pre-Employment Transition Services) Informational Interview (Division of Vocational Rehabilitation), Pre-ETS (Pre-Employment Transition Services) Job Shadow (Division of Vocational Rehabilitation), Individualized Plan for Employment (IPE) Worksheet (Division of Vocational Rehabilitation), Informational Interview Worksheet (Division of Vocational Rehabilitation), Enhanced Case Management Referral Consideration (Developmental Disabilities Administration), Service Delivery Outcome Plan: WBL - Experience A, Service Delivery Outcome Plan: WBL - Experience B, Service Delivery Outcome Plan: WBL - Experience C, 90 Day Review (Division of Vocational Rehabilitation), Jobs and Training Inventory (Division of Vocational Rehabilitation), Deaf - Blind Referral Criteria Checklist for Level 4 Community Rehabilitation Program (CRP) Services (Division of Vocational Rehabilitation), Service Delivery Outcome Plan: Pre-ETS IL Skills Training, Supported Employment Referral (Economic Services Administration), Division of Vocational Rehabilitation (DVR) Customer Job Seeker Accommodation Worksheet, Basis of Issuance Tables and Maximum Allowable Monthly Gross and Net Income Standards for the Washington Basic Food Program, Waiver of Administrative Disqualification Hearing (Community Services Division), Adult Family Home Injuries and Accidents Log, Nurse Delegation: Consent for Delegation Process, Nurse Delegation: Instructions for Nursing Task, Nurse Delegation: Assumption of Delegation, Nurse Delegation: Change in Medical Orders, Assisted Living Facility (ALF) Dementia Screening Tool, Behavioral Health Personal Care (BHPC) Request for MCO Funding (Aging and Long-Term Support Administration), Documentation of First Use of Medicaid Benefits (DDA), HCS / AAA Nursing Services Referral (Home and Community Services), Nursing Services Basic Skin Assessment (Home and Community Services), Pressure Injury Assessment and Documentation (Home and Community Services), Admissions Review Team Checklist for Admission to an ICF / IID or SONF at a Residential Habilitation Center (RHC) (Developmental Disabilities Administration), Psychoactive Medication Treatment Plan Annual Continuation of Medication, Nurse Delegation: Request For Additional Units, DDA Request for Additional Units Nurse Delegation (Developmental Disability Administration), Autistic Disorder Confirmation (Developmental Disabilities Administration), Therapy Assessment Bed Rails or Side Rails (Home and Community Services), DDA Nursing Service Referral (Developmental Disabilities Administration), CCSS Medical / Dental Services Authorization (Community Crisis Stabilization Services) (Developmental Disabilities Administration), Weekly Status Update (Competency Restoration Program) (Behavioral Rehabilitation Administration), Outpatient Competency Restoration Program (OCRP) Discharge Summary, Request for Formulary Admission or Deletion (Behavioral Health Administration), Non-Formulary Drug Use Request (Behavioral Health Administration), Non-Formulary Drug Use Request: Risperidone Consta, Aripiprazole Maintena, Paliperidone Sustenna (Behavioral Health Administration), Forensic (6358) Consultation (Behavioral Health Administration), Involuntary Antipsychotic Medication Hearing Checklist (Behavioral Health Administration), Statement of Health, Education, and Employment, Noncustodial Parent Child Support Enforcement Application, Financial Statement (Division of Vocational Rehabilitation), Interview Appointment for Applicant (Community Services Division), Your Cash and Food Assistance Rights and Responsibilities, Request for DDA Eligibility Determination, Statement of Collateral Information Summary, Application for Telecommunications Equipment, Adult Assessment Referral (Economic Services Administration), Level One Pre-Admission Screening and Resident Review (PASRR), Application to Convert Payment Services Only (PSO) Case to Full Collection Services, Notification of Address Disclosure Request - Part 1, Notification of Address Disclosure Request - Part 2, Eligibility Review for Long Term Services and Supports, Protective Payee Payment Plan, Case Assignment, and Closure Notice, Medical / Dental Services Authorization (Voluntary Placement Services) (Developmental Disabilities Administration), Community Crisis Stabilization Services (CCSS) Medical / Dental Services Authorization (Developmental Disabilities Administration), Statement of Adult Acting in Loco Parentis (As a Parent), Washington State Combined Application Program (WASHCAP) Application, Non-Profit Organization Application for Reconditioned Telecommunications Equipment (Office of the Deaf and Hard of Hearing), Financial / Social Services Communication, Estate Recovery: Repaying the State for Medical and Long Term Services and Supports, Eligible Conditions With Age and Type of Evidence (Developmental Disabilities Administration), Notice of Insufficient Information (Developmental Disabilities Administration), Epilepsy Verification Request (Developmental Disabilities Administration), Inventory for Client and Agency Planning (ICAP) Letter, Appointment Letter for Division of Child Support (DCS) Good Cause Determination, NSA Representative Checklist forDDA Review, Requirement to Identify a Representative (Developmental Disabilities Administration), Interim Assistance Reimbursement Agreement Cover, Your Responsibility to Pay Towards Costs of Care at the Residential Habilitation Center, Your DSHS Cash or Food Assistance Benefits, Your Rights (Home and Community Services), Incapacity Review for Medical Care Services, Chemical Dependency Treatment Verification Request, Substance Use Disorder Requirements (HEN Referral Program), Substance Use Disorder Requirements (ABD / PWA), SDCP Eligibility Checklist (Home and Community Services), Notice of Insufficient Information for Reapplication (Developmental Disabilities Administration), Pre-Admission Screening and Resident Review (PASRR) Addendum, ABAWD Requirement: Medical Report (Able Bodied Adults without Dependents), Application for New Program Certification (Domestic Violence Intervention Treatment), Application for Renewal Program Certification (Domestic Violence Intervention Treatment), Continuing Education Summary for DVPT Providers (Domestic Violence Intervention Treatment), Continuing Care Retirement Community (CCRC) Registration Application, Job Foundation Application (Developmental Disabilities Administration), Adult Family Homes (AFH) State Civil Penalty Reinvestment Program Grant Application, Request for Enrollment in Developmental Disabilities Administration (DDA) Home and Community Based Services (HCBS) Waiver or Request to Change from One DDA HCBS Waiver to Another, Notification of Annual Assessment Review and Person Centered Services Planning Meeting, Person Centered Service Planning and Annual Assessment Meeting, Person Centered Service Plan Meeting Survey (Developmental Disabilities Administration), HCBS Waiver Enrollment Database Update (Developmental Disabilities Administration), Client Necessary Supplemental Accommodation Representative Requirement Checklist, DDA Crisis Diversion Bed Referral and Intake Information, Annual Assessment Checklist (Developmental Disability Administration), Private Duty Nursing Logs and Skilled Nursing Tasks Log, DDA Community Protection Program Chaperone Agreement, Client Referral Summary (Developmental Disabilities Administration), Community Protection Treatment Worksheet Quarterly Review, Staff Add-on Request for Client Specific Need (Developmental Disabilities Administration)), Individual and Family Services Assessment Worksheet (Developmental Disabilities Administration), Provider Progress Report of Behavior Management and Consultation and Staff/Family Training and Consultation Services (DDA), Provider Consent For Use of Restrictive Procedures Requiring an ETP, Alternative Living Certification Evaluation (Developmental Disabilities Administration), Certified Community Residential Services and Support Initial Application, Medically Intensive Children's Program (MICP) Application, Staffed Residential Cost of Care Adjustment Request, Documentation of Early Support for Infants and Toddlers (ESIT) for Developmental Disabilities Administration, Request for Adult Family Home Application Fee Waiver, Resident Choice Regarding Assisted Living Facility (ALF) Room Requirements (Home and Community Services), Adult Family Home Disclosure of Charges Required by RCW 70.128.280, RCS Character, Competence and Suitability (CSS) Determination for Unsupervised Access to Minors and Vulnerable Adults, Adult Family Home Notice of Transfer or Change, Notification of Age 18 Eligibility Expiration, Notification of Age 20 Eligibility Expiration, Notification Regarding Request to Exceed Work Week Limit (Home and Community Services) - TRANSLATIONS ONLY, Medicaid Transformation Demonstration Service Notice, Guardian / Family Response to Individual Habilitation Plan (IHP) Notification (Developmental Disabilities Administration), Individual Habilitation Plan (IHP) (Developmental Disabilities Administration), Individual Habilitation Plan (IHP) Revision (Developmental Disabilities Administration), Notification of Initial Assessment Request (Developmental Disabilities Administration), Consent and Service Agreement (Developmental Disabilities Administration), Provider Progress Report of Community Guide and Engagement Services (Developmental Disabilities Administration)), Companion Home and Alternative Living Services Incident Report (Developmental Disabilities Administration), Companion Home (CH) Client Individual Financial Plan (IFP) (Developmental Disabilities Administration), CCSS Family Agreement (Community Crisis Stabilization Services) (Developmental Disabilities Administration), Companion Home Quarterly Report (Developmental Disabilities Administration), Application for Transition from Group Home to Group Training Home, Continuing Education Event Approval Application (Aging and Long-Term Support Administration), Adult Family Home Administrator Training Instructor Application (Home and Community Services), Community Instructor Application: DSHS Adult Education (Home and Community Services), Community Instructor Application (Home and Community Services), Community Instructor Training Program Application and Updates (Home and Community Services), Curriculum Approval Application (Home and Community Services), Long-Term Care Worker Basic Training Enhancement Instructions and Application (Home and Community Services), Facility Instructor Application (Home and Community Services), Facility Training Program Application and Updates (Home and Community Services), Continuing Care Retirement Community (CCRC) Registration Renewal Addendum (Aging and Long-Term Support Administration), Adult Family Home (AFH) Resident Significant Change Assessment Request, Adult Family Home Referral Request (Developmental Disabilities Administration), Room Requirements Checklist (Home and Community Services), Residential Quarterly Report for Children's Residential Services (Developmental Disabilities Administration), Nursing Home (NH) Complaint Investigation (CI) Skill Building Tool, On-the-Job Facility Training Plan Application and Updates (Home and Community Services), DDA Alternative Living Provider Orientation (Developmental Disabilities Administration), Notice of Termination of Service (Developmental Disabilities Administration), Enhanced Services Facility (ESF) Pre-Inspection Preparation, Enhanced Services Facility (ESF) Request for Documentation, Enhanced Services Facility (ESF) Resident List, Enhanced Services Facility (ESF) Resident Characteristic Roster and Sample Selection, Enhanced Services Facility (ESF) Resident Interview, Enhanced Services Facility (ESF) Other Contact Inverview, ced Services Facility (ESF) Environmental Observations, Enhanced Services Facility (ESF) Resident Record Review, Enhanced Services Facility (ESF) Staff and Administrative Record Review, Enhanced Services Facility (ESF) Training Requirements, Enhanced Services Facility (ESF) Notes / Worksheets, Enhanced Services Facility (ESF) Exit Preparation Worksheet, Enhanced Services Facility (ESF) Food Service Observations and Interviews, Enhanced Services Facility (ESF) Medication Pass Worksheet, Enhanced Services Facility (ESF) Staff Schedule Worksheet, Enhanced Services Facility (ESF) Pre-Inspection Packet, NonAssistance Support Enforcement Information (Division of Child Support), Noncustodial Parent's Rights and Responsibilities, Your Rights and Responsibilities When You Receive Services Offered by Aging and Disability Services Administration and Developmental Disabilities Administration, Guidelines for Completing the ICAP / SIB-R Adaptive Behavior Scale (Developmental Disabilities Administration), SOLA Vehicle Trip Log (Developmental Disabilities Administration), Information About Your Role as the Identified Necessary Supplemental Accommodation (NSA) Representative, Assisted Living Facility Policies and Procedures Attestation, Individual Provider Notification: Stop Work Notice, New Case/Resource Manager Technology Training Checklist, Memo to Provider for Behavior Support, Counseling, and Consultation Services, New Case / Resource Manager Assessment (Developmental Disabilities Administration), 5-Day Investigation Report (Developmental Disabilities Administration (DDA), Corrective Action Plan (5-Day Investigation) (Developmental Disabilities Administration), SIS-A Rating Key (Developmental Disabilities Administration), Vulnerable Adult Statement of Rights (Intended for use in NH, ALF, AFH, ICF/IID (non RHC) and ESF), Vulnerable Adult Statement of Rights (Intended for use in CCRSS and ICF/IID (RHC)), DDA GovDelivery Communication Request (Developmental Disabilities Administration), Community Services Office (CSO) Compliments and Concerns (Economic Services Administration), New Freedom Participant Responsibility Agreement, Skills Practice Procedure Checklist for Home Care Aides DSHS Approved (Home and Community Services), Your rights as a client of the Developmental Disabilities Administration, AIS TRACKS Fixed Asset Inventory Local Office Certificate of Completion, Spoken Language Interpreter Service Appointment Record, Personal Information Release (Economic Services Administration), Request for Mental Health Service Information, PRISM Access Request for Multiple Organizations, Authorization for SSI Facilitation Records (Economic Services Administration), AAA DSHS / HCS Systems Access Request (Aging and Long-Term Support Administration), Pre-Admission Screening and Resident Review (PASRR) Records Request, Non-Emergency Medical Transportation (NEMT) for PASRR Program Request, Mental Incapacity Evaluation (MIE) Contractor Travel Plan, ODHH Approved Sign Language Interpreter Complaints, Residential Habilitation Center (RHC) Informed Consent (Developmental Disabilities Administration), DSHS Background Check System (BCS) Access Request, Companion Home Client Budget Worksheet (Developmental Disabilities Administration), Companion Home Client Cash Ledger (Developmental Disabilities Administration), Companion Home Gift Card or Pre-paid Credit Card Ledger (Developmental Disabilities Administration), Assistive Communication Technology (ACT) Contractor Assignment Report (Office of Deaf and Hard of Hearing), Companion Home Physical and Safety Requirements Review (Developmental Disabilities Administration), Background Check Review: Character, Competence, and Suitability for Contractor Employees / Volunteers (Division of Vocational Rehabilitation), DVR Background Check Reporting (Division of Vocational Rehabilitation), DSHS / DVR Request for Approval to Subcontract Checklist (Division of Vocational Rehabilitation), Contractor Designated Contact(s) Background Check (Division of Vocational Rehabilitation), PASRR Equipment Purchase Request (Pre-Admission Screening and Resident Review) (Developmental Disabilities Administration), Qualified Sign Language Interpreter Request (Office of Deaf and Hard of Hearing), Assistive Communication Technology (ACT) Program Service Request / Work Order for Induction Loops (Office of the Deaf and Hard of Hearing), Outpatient Competency Restoration Program Clinical Screening (Behavioral Health Administration), Residential Quality Assurance Certification Evaluation Checklist for Companion Homes Providers (Developmental Disabilities Administration), Residential Quality Assurance Certification Evaluation Checklist for Alternative Living Providers (Developmental Disabilities Administration), Removal and Transport Directive (Behavioral Health Administration), Vendor Agreement Information (Behavioral Health Administration), BHA Personal Information Release (Behavioral Health Administration), Medical Expense Examples (Community Services Division, Economic Services Administration), Application for Nonassistance Support Enforcement Services, Initial payment (Interim Assistance Reimbursement Authorization), How You Must Help with Child Support Collection for Temporary Assistance for Needy Families (TANF) and Medical Assistance Programs, Social Service Incorrect Payment Computation, Non-SSPS Client / Provider Overpayment AFRS Coding Computation, Declaration of Support Payments (Division of Child Support), New Hire Reporting Methods and Instructions (Division of Child Support), New Hire Reporting Methods and Instructions, Employer Payment Identification Instructions, Automatic Payment Authorization and Electronic Funds Transfer Information, SSP Client Overpayment Notice (State Supplementary Program), Request for Collection of Uninsured Health Care Expenses, Detail Sheet – Uninsured Health Care Expenses, Request for Income Information for Purposes of Entering or Enforcing a Child Support Order, Loan Agreement for Tools, Equipment, Initial Stock and Supplies, and Devices (Division of Vocational Rehabilitation), Application Budget Summary (Residential Care Services), Family Agreement to Children's Intensive In-home Behavioral Support (CIIBS) Program, Incident Report to DDA (Developmental Disabilities Administration), Appropriate Level of Forensic Services (ALFS) Screening Tool, Outpatient Competency Restoration Program (OCRP) Transition Plan (Behavioral Health Administration), Children's Staffed Residential Quality Assurance Assessment, Children’s State Operated Living Alternative (SOLA) Quality Assurance Assessment, Companion Home Monthly Emergency Evacuation Practice and Water Temperature Record (Developmental Disabilities Administration), Alternative Living Monthly Financial Report, Community Services Division (CSD) Financial Confidence Wheel (Economic Services Division), Contractor Information Update (for existing DSHS contractors), Voluntary Placement Services Provider Referral Letter (DDA), Voluntary Placement Services For Youth (Age 18-21), Mandatory Reporting of Abuse, Neglect, Personal and Financial Exploitation, or Abandonment of a Child or Vulnerable Adult, Employment and Day Program Services Providers: Mandatory Reporting of Abuse, Improper Use of Restraint, Neglect, Personal or Financial Exploitation, Abandonment of a Child or Vulnerable Adult (Developmental Disability Administration), Fingerprint-Based Background Check Notice, Medicaid Provider Disclosure Statement (Aging and Long-Term Support Administration), Permission to Share Documents for Reimbursement of Health Care Expenses, Applicant Request for a Copy of Background Check Information, HCS / AAA / DDA Individual Provider Contractor Intake, Provider Owned Housing Memorandum of Understanding Renter Attestation, Provider Owned Housing Memorandum of Understanding Residential Provider Attestation, Authorization for Alternate EBT Cardholder, CSD ABD Medical Evidence Review Contractor Self-Assessment Monitoring Tool, CSD Disability Eligibility Review Contractor Self-Assessment Monitoring Tool, Housing Modification Property Release Agreement, Notice and Consent of Communication via Text, DVR Additional Contractor Information (Division of Vocational Rehabilitation), Release of Liability (Developmental Disabilities Administration), Adult Protective Services (APS) Administrative Hearing Request, Adult Family Home (AFH) Informal Dispute Resolution (IDR) Request (Residential Care Services), DSHS Request for Positive Identification – Thumbprint, Initial Opiate Prescription Informed Consent (Behavioral Health Administration), Asset Verification Authorization (Home and Community Services), Home and Community Services (HCS) Resumption of Training Attestation, Complimentary Therapies Agreement (Developmental Disabilities Administration). 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