California Balance Sheet (LIC 403) – Fill Out and Use This PDF

California Balance Sheet (LIC 403) PDF Details

The California Balance Sheet (LIC 403), issued by the California Department of Social Services Community Care Licensing Division, provides a complete picture of an entity's financial position at a specific point in time. Every applicant and licensee must submit this form during the initial licensing process and at each renewal.

The form captures two main categories of financial information:

• Assets – Current assets such as cash on hand and accounts receivable, plus long-term assets including real property and equipment, totaled to produce Total Assets.
• Liabilities – Short-term obligations including salaries and wages payable and taxes payable, plus long-term debts such as mortgages, auto loans, and equipment loans, totaled to produce Total Liabilities.

Total equity is then calculated by subtracting Total Liabilities from Total Assets. The LIC 403 applies to sole proprietorships, partnerships, and corporations alike. All assets and liabilities of the entity must be reported, not just those tied to the care facility operations.

Before completing the LIC 403, applicants must first fill out the LIC 403a supplemental schedule. This companion form provides the line-by-line asset and liability detail that supports the summary figures reported on the balance sheet. Both forms are submitted together as part of the licensing or renewal package.

For related financial documents, see the Projected Balance Sheet, the Model Balance Sheet, and the Individual Financial Statement.