Lic 308 Form PDF Details

The Lic 308 form is an important document for employers and employees in the state of California. Anyone who hires personnel or is hired as a permanent employee must complete this form, which helps ensure that workers are properly registered with the Employment Development Department (EDD). In addition to serving a crucial compliance role, completing Form LIC 308 also lets employers and their workers establish eligibility for Social Security benefits, Unemployment Insurance Funds program services, tax deductions, and other employment-related matters. Keep reading to learn more about the process of filing this significant document and why it's so important to fully understand your obligations when completing it.

QuestionAnswer
Form NameLic 308 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namescalifornia lic308, lic308, lic 308 facility, lic 308 designation of facility responsibility

Form Preview Example

STATE OF CALIFORNIA—HEALTH AND HUMAN SERVICES AGENCY

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

 

COMMUNITY CARE LICENSING

DESIGNATION OF FACILITY RESPONSIBILITY

Licensed facilities are required to have an authorized person continuously present at the facility during operational hours to represent the facility and to accept licensing reports. Licensees shall use this form to delegate the above authority to appropriate staff. Applicants/licensees who are corporations shall attach board resolutions authorizing this delegation.

Facility Name _______________________________________________________________ Date ____________________________

Facility Number _____________________________________________________________

Facility Address _____________________________________________________________ Phone ___________________________

City ______________________________________________________________________ County __________________________

In the event of my absence I designate ___________________________________________________________________. He/She is

NAME

authorized to receive any documents including reports of inspections and consultations, accusations and civil and administrative processes on my behalf at the above-named facility.

When delegating authority to appropriate staff, Residential Care Facilities for the Elderly shall comply with CCR Title 22, Division 6 Section 87564. Child Care Centers shall comply with CCR Title 22, Division 12 Section 101215.1 and other licensed facilities shall comply with CCR Title 22, Division 6 Section 80064.

I (We) shall notify the licensing agency, in writing, within 10 days of any change in the above authorization.

________________________________________

Signature of applicants/licensees

_____________________________________________

Title

_____________________________________________

Address

_____________________________________________

City

County

Zip

LIC 308 (11/02) (PUBLIC)

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1. To start with, once completing the lic 308 form, start with the area that features the subsequent fields:

Completing section 1 in designation of facility responsibility

2. Just after performing this step, go to the next stage and enter the essential particulars in these blanks - Signature of applicantslicensees, Title, Address, City, County, Zip, and LIC PUBLIC.

Ways to fill out designation of facility responsibility stage 2

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