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The Lic 309 form is an essential document for corporations and limited liability companies operating in California's health and human services sector. It ensures that the Licensing Agency is kept up-to-date with organizational changes such as shifts in partners, officers, or company structure. Each time there’s a modification, this form must be updated and submitted according to California regulations. Key details required on the form include the facility's name, address, and number, as well as specific information about the organization's legal status, such as the incorporation date and officers' details. Essential attachments include copies of the Articles of Incorporation, By-Laws, and any resolutions pertinent to the application for corporations. For out-of-state applicants, a California representative's information must also be provided, ensuring compliance with local business regulations. Furthermore, it calls for an inventory of individuals holding a significant interest in the entity, listing directors and managing members, and in some cases, public agencies or partnerships must also provide detailed legal documents. Essentially, the Lic 309 form serves as a vital communication tool between the operating entity and the state, facilitating transparency and accountability in the provision of community care services.

Lic 309 Example

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

ADMINISTRATIVE ORGANIZATION

(This side is for corporations and limited liability companies only. See reverse for public agencies, partnerships, and other associations.)

INSTRUCTIONS: This form must be updated and submitted to the Licensing Agency each time there is a change in partners, officers or changes in the corporation or limited liability company as provided in the Callifornia Code of Regulations Title 22, Section 80034(a)(2), or 87235(a)(5), or 101185(a)(2).

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

COMMUNITY CARE LICENSING DIVISION

DATE

FACILITY NAME

FACILITY ADDRESS

FACILITY NUMBER

I. CORPORATION/LIMITED LIABILITY COMPANY (LLC)

1. Name (as filed with Secretary of State)

2.Chief Executive Officer

3.Incorporation/Registration Date

4.Place of Incorporation/Registration

Corporation/Limited Liability Company Number

5.Please attach (1) A copy of Articles of Incorporation or organization and any amendments (2) A copy of By-Laws or Operating Agreement and any amendments (3) A copy of Resolution authorizing the filing of this application (for Corporations only).

6.Principal office of business:

Address

City

Zip Code

County

Telephone No.

Contact Person:

Title:

 

Telephone No.:

 

7. Out of state or foreign applicants complete the following:

 

 

 

a. Name of California Representative

 

Address

Zip Code

Telephone No.

b.Please attach a copy of a foreign corporation’s or foreign LLC’s registration to do business in California.

8.Names and addresses of all persons who own ten percent (10%) or more interest in corporation or LLC. Attach sheet for additional space.

9.Directors (Corporation)/Managers and Managing Members (LLC)

a.Number of Directors/Managers & Managing Members

b.Term of Office (if applicable)

c.Frequency of Meetings (if applicable)

d.Method of Selection (corporations only)

10.Officers: (For LLCs without officers, skip this section and go to Section II)

Office

Name

Principal Business Address & City & Zip Code

(other than facility address)

 

 

Telephone No.

Term Expires

President

Vice-President

Secretary

Treasurer

LIC 309 (6/01) (PUBLIC)

11.List all Directors (Corporations)/Managers and Managing Members (LLC)

Name

Mailing Address & City & Zip Code

Telephone No.

Term Expires

(Attach Sheet for additional space)

II.PUBLIC AGENCY

1. Check type of public agency:

Federal

State

County

City

Other, specify below

2.Agency providing services:

Name: _______________________________________________ Address: ___________________________________________________________

CITY/STATE

Mailing Address: _____________________________________________________________________________________________________________

 

CITY/STATE/ZIP CODE

Contact Person: __________________________________

Title: ___________________________________ Phone No.:_______________________

3.District or Area to be served: (attach map if necessary) Specify geographic area:

4.Attach copy of Resolution or legal document authorizing this application.

III.PARTNERSHIPS

Attach a copy of partnership agreement (attach additional sheet if necessary)

1st Partner

General

Name

 

 

 

 

TELEPHONE NUMBER

 

Limited

Principal Business Address

 

 

 

 

CITY/STATE

2nd Partner

General

Name

 

 

 

 

TELEPHONE NUMBER

 

Limited

Principal Business Address

 

 

 

 

CITY/STATE

3rd Partner

General

Name

 

 

 

 

TELEPHONE NUMBER

 

Limited

Principal Business Address

 

 

 

 

CITY/STATE

4th Partner

General

Name

 

 

 

 

TELEPHONE NUMBER

 

Limited

Principal Business Address

 

 

 

 

CITY/STATE

Contact Person: _______________________________ Title: __________________________________ Telephone No.: ___________________

IV. OTHER ASSOCIATIONS

Other associations must also provide a similar list of persons legally responsible for the organization, contact person, appropriate legal documents which set forth legal responsibility of the organization and accountability for operating the facility.

Form Characteristics

Fact Name Description
Purpose of LIC 309 This form serves as a necessary document for corporations and limited liability companies to inform the Licensing Agency about changes in their organizational structure, such as changes in partners, officers, or other significant shifts.
Governing Laws The LIC 309 form is governed by the California Code of Regulations, particularly Title 22, Sections 80034(a)(2), 87235(a)(5), and 101185(a)(2). These regulations outline the proper protocols for maintaining up-to-date licensing information.
Submission Requirements Along with the completed form, applicants must attach specific documentation, including Articles of Incorporation, bylaws, and any resolutions that authorize the application, ensuring legality and compliance.
Update Frequency Any time there is a change in the organizational structure, the LIC 309 form must be updated and resubmitted promptly to the Licensing Agency to maintain compliance and transparency.
Eligibility The LIC 309 form is specifically designed for corporations and limited liability companies. Other types of organizations, such as public agencies or partnerships, have different forms and requirements for reporting changes.

Guidelines on Utilizing Lic 309

Completing the Lic 309 form is an important process for corporations and limited liability companies that need to keep their licensing information current. It’s essential to ensure that all required information is accurately provided and necessary documents are attached to help facilitate a smooth review by the Licensing Agency.

  1. Start by obtaining a blank copy of the Lic 309 form.
  2. Fill in the date at the top of the form.
  3. Enter the facility name, address, and facility number in the appropriate fields.
  4. Provide the name of your corporation or limited liability company as filed with the Secretary of State.
  5. Include the name of the Chief Executive Officer.
  6. State the incorporation or registration date.
  7. Indicate the place of incorporation or registration along with the corporation or LLC number.
  8. Attach the following documents:
    • A copy of the Articles of Incorporation or organization and any amendments.
    • A copy of the By-Laws or Operating Agreement and any amendments.
    • A copy of the Resolution authorizing the filing of this application (for Corporations only).
  9. Provide the principal business address, city, zip code, county, and telephone number.
  10. Identify a contact person along with their title and telephone number.
  11. If applicable, for out-of-state or foreign applicants, provide the California representative's name, address, and telephone number.
  12. List all individuals who own ten percent (10%) or more interest in the corporation or LLC. Attach additional sheets if necessary.
  13. For corporations, indicate the number of Directors and their term of office, frequency of meetings, and method of selection.
  14. For LLCs, skip to the Officers section if applicable. Otherwise, if your LLC has officers, list their office titles, names, principal business addresses, telephone numbers, and term expiration dates.
  15. List all Directors, Managers, and Managing Members along with their names, mailing addresses, telephone numbers, and term expiration dates. Attach an extra sheet if necessary.

After filling out the form, double-check that all information is complete and accurate. This will help prevent delays in processing your application. Additionally, once everything is finalized, you can submit the form along with the required attachments to the Licensing Agency as instructed.

What You Should Know About This Form

What is the purpose of the Lic 309 form?

The Lic 309 form is designed to provide essential information about the ownership and management structure of specific entities, such as corporations and limited liability companies, applying for or maintaining a license in California. Each time there is a change in the partners, officers, or the organizational structure of these entities, the form must be updated and submitted to the appropriate Licensing Agency. Compliance ensures that the agency has current and accurate details about who is responsible for managing community care facilities.

Who is required to fill out the Lic 309 form?

This form must be completed by corporations and limited liability companies seeking a license, as stated in the California Code of Regulations, Title 22. Additionally, public agencies and partnerships are subject to similar requirements but need to use the reverse side of the Lic 309 form. Therefore, if your organization falls under any of these categories, ensure that you follow the instructions and accurately represent your business structure.

What documents must accompany the Lic 309 form?

When submitting the Lic 309 form, certain documents are mandatory. Corporations must attach a copy of their Articles of Incorporation or organization, along with any amendments. They must also include a copy of their By-Laws or Operating Agreement, and for corporations specifically, a copy of the Resolution authorizing the filing of the application. If the business is a foreign corporation or LLC, proof of registration to do business in California is also required. It’s critical to provide all necessary documentation to avoid delays in the application process.

What happens if there are changes to the organization?

Any time there are changes in partners, officers, or the structure of the corporation or LLC, the Lic 309 form must be revised and submitted again. This ongoing requirement is crucial for maintaining transparency and accountability within the licensing framework. Failure to update the form promptly may result in complications concerning your license status or could lead to penalties, so stay proactive in ensuring that your information is always current.

How do I find more information about the regulations related to the Lic 309 form?

For detailed guidelines, individuals can refer to the California Code of Regulations, specifically Title 22, which outlines the requirements for the Lic 309 form and related processes. The California Department of Social Services’ Community Care Licensing Division also provides resources, including instructional materials and contact information for representatives, who can answer any specific questions regarding the form or the licensing process. Engaging with these resources can significantly streamline your understanding and compliance efforts.

Common mistakes

Filling out the LIC 309 form can seem straightforward, but many individuals make mistakes that can delay the licensing process or cause complications later on. Below are some common errors to watch out for when completing this important document.

One frequent mistake occurs when applicants fail to update their information promptly. It is crucial to submit the LIC 309 form each time there are changes in partners, officers, or the organization itself. Forgetting to do so can lead to compliance issues with the California Code of Regulations.

Inaccurate information tends to be a major issue. For instance, when listing the corporation or LLC name, it should match exactly as filed with the Secretary of State. Any discrepancies can raise flags and delay processing. Additionally, many skip the step of providing a copy of essential documents, such as the Articles of Incorporation or Operating Agreement, which are required attachments.

Another mistake lies in how contact information is presented. Applicants should ensure that the telephone numbers and addresses are correct and up-to-date. Mismatched data can make it challenging for the licensing agency to reach out, resulting in unnecessary delays.

Some also overlook the requirement for additional documentation. While filling out the form, including items like a copy of the resolution authorizing the application for corporations is essential. Not attaching these documents can lead to rejection of the application.

Measuring ownership interests can be tricky. Properly identifying and listing individuals who own ten percent or more interest in the corporation or LLC is vital. Providing inaccurate percentages or omitting owners can cause issues with transparency and trust.

Failure to gather proper signatures on the form adds another layer of complexity. All required signatures must be included; otherwise, the application may be considered incomplete. Sometimes individuals hesitate to include the California Representative, which can also hinder out-of-state applicants.

For corporations, neglecting to report on the number of directors or managers can lead to questions from the licensing agency. Providing information on terms of office, frequency of meetings, and method of selection is essential for a complete submission.

In partnerships, some individuals forget to specify whether partners are general or limited, which is critical information. Clearly distinguishing between these types helps the agency understand the structure of the partnership more thoroughly.

Lastly, many applicants fail to review their completed forms before submission thoroughly. Taking the time to cross-check all sections may prevent uncomplicated errors that could complicate the application process.

By paying attention to these common pitfalls, applicants can streamline their experience and significantly enhance their chances of a successful submission. Proper diligence can lead to a smoother licensing journey!

Documents used along the form

Understanding the paperwork involved in facility licensing is critical for successful compliance. The Lic 309 form is just one component of a broader set of documents that may need to be submitted or maintained. Each of these documents plays a role in ensuring that your organization operates within the legal framework and meets the necessary regulatory requirements.

  • Articles of Incorporation: This document outlines the fundamental details of the corporation, including its purpose, structure, and registered address. It must be filed with the Secretary of State and is essential for establishing the legal existence of the corporation.
  • By-Laws or Operating Agreement: This internal document governs the operation of the company, detailing the rules for management, responsibilities of officers, and protocols for meetings. It should be consistent with state laws and reflect how the organization will function.
  • Resolution Authorizing Application: A formal resolution is often required for corporations to approve the submission of certain applications, including licenses. This document confirms that the application aligns with the organization’s goals as documented by the board.
  • Partnership Agreement: For organizations structured as partnerships, this agreement outlines the terms of the partnership, rights, and duties of each partner, and the process for resolving disputes. It serves as a foundational document for the partnership.
  • Foreign Corporation Registration: If a corporation or LLC is registered outside of California but wishes to operate in the state, it must register as a foreign entity. This document verifies that it has authority to do business in California.
  • Map of Geographic Area Served: For certain facilities, providing a map that delineates the area served is necessary. This document helps authorities understand the community impact and operational scope of the facility.
  • Legal Authorization Document: Public agencies must include a copy of the legal document or resolution that authorizes their application. This confirms the agency’s legitimacy and its commitment to the governance structure.

Each document mentioned above is interlinked with the Lic 309 form and adds clarity to the licensing process. It is crucial to maintain accurate records and ensure all paperwork is completed correctly to avoid future compliance issues. Keeping organized and informed will help your organization operate smoothly while fulfilling all legal obligations.

Similar forms

The Lic 309 form is an essential document for corporations and limited liability companies in California, primarily used to report organizational changes. Similar documents serve specific regulatory purposes and share key functions in ensuring compliance and accountability. Below are seven documents that resemble the Lic 309 form.

  • Articles of Incorporation: This document officially establishes a corporation's existence. It includes important details such as the corporation's name, purpose, and the number of shares it's authorized to issue. Like the Lic 309, it requires updates when significant changes occur.
  • By-Laws: These are the rules that govern the internal management of a corporation. By-laws need to be kept current with changes to board members or operational procedures, paralleling the licensing updates required in the Lic 309.
  • Operating Agreement: For limited liability companies, this document outlines the management structure and operating procedures. Changes in membership or management must be documented, similar to the updates needed for the Lic 309 form.
  • Partnership Agreement: This agreement details the terms of a partnership. It requires updates when there are changes in partners or terms of partnership, akin to the requirements of the Lic 309.
  • Resolution Authorizing Filing: Corporations need a resolution to support the filing of their applications. This resolution verifies the authority of the individuals filing on behalf of the corporation, similar in nature to how the Lic 309 provides necessary authorization details.
  • Foreign Qualification Registration: If an out-of-state corporation wishes to operate in California, it must file for foreign qualification. This registration must stay current to ensure compliance, paralleling the ongoing requirements related to the Lic 309.
  • Annual Report: Many corporations and LLCs are required to file annual reports to inform the state of significant changes. The updates to these reports share a purpose with the Lic 309, ensuring transparency in business operations.

Dos and Don'ts

When filling out the Lic 309 form, there are important guidelines to follow. Adhering to these can help ensure a smooth application process, while neglecting them can lead to delays or complications. Here’s a list of dos and don'ts for completing this form:

  • Do ensure all information is accurate and up-to-date, particularly regarding the organization’s structure.
  • Do attach all required documents, such as Articles of Incorporation and a copy of the Operating Agreement.
  • Do include names and addresses of individuals holding ten percent or more interest in the organization.
  • Do specify the type of public agency if applicable, and include supporting documentation.
  • Don’t leave any required fields blank, as this could result in your application being returned.
  • Don’t forget to provide a current contact person’s information for follow-up queries.

Misconceptions

Understanding the Lic 309 form is crucial for compliance with California's licensing regulations. However, several misconceptions often arise concerning this form. Below is a list of common misunderstandings along with clarifications to help navigate the requirements.

  • The Lic 309 form is only for corporations.
  • This form is not limited to corporations; it also applies to limited liability companies (LLCs), public agencies, partnerships, and other associations, each having specific requirements based on their classification.

  • Submitting the Lic 309 is optional.
  • Submission of the Lic 309 form is mandatory whenever there are changes in partners, officers, or the organizational structure, as stipulated in the California Code of Regulations.

  • Only new entities need to fill out the Lic 309 form.
  • Even established entities must update and submit this form to reflect any changes. It is important to keep the licensing agency informed about organizational changes.

  • The Lic 309 form only requires current information.
  • In addition to current information, the form requires relevant attachments like articles of incorporation, by-laws, and resolutions, ensuring a thorough understanding of the organization’s structure.

  • Once submitted, the information does not need to be revised.
  • Entities are responsible for maintaining accurate records and must submit updated forms reflecting any changes. This includes ownership interest, directorship, and management structures.

  • Any person with ownership interest must be listed.
  • Only individuals who own ten percent (10%) or more interest in the corporation or LLC need to be reported on the form. This allows for a focus on significant stakeholders.

  • The licenses can be filed online without the need for documentation.
  • While electronic filing may be available, the required documentation such as articles and operating agreements must still be attached. Paper copies may also be needed for compliance.

  • Changes can be reported at any time without consequence.
  • Timely reporting is essential. Failing to update the form promptly can lead to compliance issues or potential penalties from the licensing agency.

Key takeaways

Here are some key takeaways for filling out and using the Lic 309 form:

  • The Lic 309 form is specifically for corporations and limited liability companies (LLCs) in California.
  • It must be updated and submitted to the Licensing Agency whenever there are changes in partners, officers, or significant structural changes in the corporation or LLC.
  • Important documents to attach include Articles of Incorporation, By-Laws or Operating Agreements, and any resolutions authorizing the filing of the application.
  • Out-of-state or foreign entities must provide specific information about their California representative and attach proof of registration to operate in California.
  • Ensure that all individuals owning 10% or more of the corporation or LLC are listed on the form.
  • Contact information for a designated person is mandatory, including their title and phone number, to facilitate communication with the Licensing Agency.