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Lic 700 Form PDF Details

Are you looking for a way to make your business more professional and organized? If so, you may want to consider using the Lic 700 form. This form is used to help businesses keep track of their employees' licenses and permits. By using the Lic 700 form, you can ensure that your business is in compliance with all licensing requirements. Additionally, using the Lic 700 form can help you keep track of employee expiration dates and renewals.

This article includes specifics of lic 700 form. You may want to study it just before filling in the form.

Question	Answer
Form Name	Lic 700 Form
Form Length	1 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	15 sec
Other names	lic 700 form no download needed, lic700, identification and emergency information lic 700, lic 700 form english

12

Form Preview Example

STATE OF CALIFORNIA	CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
HEALTH AND HUMAN SERVICES AGENCY	COMMUNITY CARE LICENSING DIVISION

IDENTIFICATION AND EMERGENCY INFORMATION

CHILD CARE CENTERS/FAMILY CHILD CARE HOMES

To Be Completed by Parent or Authorized Representative

CHILD’S NAME

LAST

MIDDLE

FIRST

SEX

TELEPHONE

								(	)
ADDRESS	NUMBER	STREET			CITY	STATE	ZIP	BIRTHDATE

FATHER’S/GUARDIAN’S/FATHER’S DOMESTIC PARTNER’S NAME			LAST	MIDDLE		FIRST		BUSINESS TELEPHONE
								(	)

HOME ADDRESS	NUMBER	STREET			CITY	STATE	ZIP	HOME TELEPHONE
								(	)

MOTHER’S/GUARDIAN’S/MOTHER’S DOMESTIC PARTNER’S NAME			LAST	MIDDLE		FIRST		BUSINESS TELEPHONE
								(	)

HOME ADDRESS	NUMBER	STREET			CITY	STATE	ZIP	HOME TELEPHONE
								(	)

PERSON RESPONSIBLE FOR CHILD		LAST NAME		MIDDLE	FIRST	HOME TELEPHONE		BUSINESS TELEPHONE
						(	)	(	)

ADDITIONAL PERSONS WHO MAY BE CALLED IN AN EMERGENCY

NAME

ADDRESS

TELEPHONE

RELATIONSHIP

PHYSICIAN OR DENTIST TO BE CALLED IN AN EMERGENCY

PHYSICIAN		ADDRESS	MEDICAL PLAN AND NUMBER	TELEPHONE
				(	)

DENTIST		ADDRESS	MEDICAL PLAN AND NUMBER	TELEPHONE
				(	)

IF PHYSICIAN CANNOT BE REACHED, WHAT ACTION SHOULD BE TAKEN?
■ CALL EMERGENCY HOSPITAL	■ OTHER	EXPLAIN: ____________________________________________________________________________________________________________________

NAMES OF PERSONS AUTHORIZED TO TAKE CHILD FROM THE FACILITY

(CHILD WILL NOT BE ALLOWED TO LEAVE WITH ANY OTHER PERSON WITHOUT WRITTEN AUTHORIZATION FROM PARENT OR AUTHORIZED REPRESENTATIVE)

NAME

RELATIONSHIP

TIME CHILD WILL BE CALLED FOR

SIGNATURE OF PARENT/GUARDIAN OR AUTHORIZED REPRESENTATIVE

DATE

TO BE COMPLETED BY FACILITY DIRECTOR/ADMINISTRATOR/FAMILY CHILD CARE HOMES LICENSEE

DATE OF ADMISSION

LIC 700 (8/08)(CONFIDENTIAL)

DATE LEFT

How to Edit Lic 700 Form Online for Free

We have applied the efforts of the best computer programmers to create the PDF editor you may want to apply. The application will let you fill in the lic700 document easily and don’t waste time. What you need to do is stick to the next easy-to-follow steps.

Step 1: Look for the button "Get Form Here" on the following site and hit it.

Step 2: At the moment, you can change your lic700. Our multifunctional toolbar lets you insert, delete, customize, highlight, and also undertake other sorts of commands to the content material and areas within the file.

The next parts are what you are going to complete to have the prepared PDF file.

example of gaps in lic 700 form no download needed

The system will expect you to complete the DENTIST, ADDRESS, MEDICAL PLAN AND NUMBER, TELEPHONE, IF PHYSICIAN CANNOT BE REACHED, CALL EMERGENCY HOSPITAL, OTHER, EXPLAIN, NAMES OF PERSONS AUTHORIZED TO, NAME, RELATIONSHIP, TIME CHILD WILL BE CALLED FOR, SIGNATURE OF PARENTGUARDIAN OR, DATE, and DATE OF ADMISSION field.

step 2 to completing lic 700 form no download needed

Step 3: As soon as you've clicked the Done button, your document is going to be available for upload to every electronic device or email address you indicate.

Step 4: You could make duplicates of your document toavoid any possible concerns. You should not worry, we cannot publish or track your information.

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