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Change of Licensee-in-Charge West Virginia Board of Funeral Service Examiners 179 Summers Street, Suite 305 Charleston, WV 25301 Voice 304.558.0302 Fax 304.558.0660 Funeral Establishment Requesting

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What is licensee-in-charge change form?

The licensee-in-charge change form is a document used to notify regulatory authorities of a change in the designated individual responsible for overseeing the operations and compliance of a licensed entity.

Who is required to file licensee-in-charge change form?

Any licensed entity that undergoes a change in their licensee-in-charge individual is required to file the licensee-in-charge change form.

How to fill out licensee-in-charge change form?

To fill out the licensee-in-charge change form, you need to provide the necessary information about the licensed entity, the previous licensee-in-charge, and the new licensee-in-charge. The form typically includes sections to input personal details, dates of the change, and any supporting documentation.

What is the purpose of licensee-in-charge change form?

The purpose of the licensee-in-charge change form is to ensure regulatory compliance by keeping authorities informed about changes in the designated individual responsible for overseeing the operations and compliance of a licensed entity.

What information must be reported on licensee-in-charge change form?

The licensee-in-charge change form usually requires details such as the name, contact information, license number of the licensed entity, the previous licensee-in-charge, the new licensee-in-charge, effective date of the change, and any supporting documentation as required by the regulatory authorities.

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