Get the free Sworn Statement - CDPH - CA.gov

State of California Health and Human Services Agency California Department of Public HealthSWORN STATEMENT I, declare under penalty of perjury under the laws of the State of California, that I am

How to fill out sworn statement - cdph

How to fill out sworn statement - cdph

1. To fill out a sworn statement for the CDPH, follow these steps:
2. Begin by providing your personal information, including your full name, address, and contact details.
3. Specify the purpose of the sworn statement and the case or matter it relates to.
4. Clearly state the facts or information that you are swearing to be true.
5. Date and sign the statement in the presence of a notary public or other authorized person.
6. Include any relevant supporting documents or evidence, if required.
7. Make copies of the completed sworn statement for your records.
8. It is important to read and understand the specific requirements and instructions provided by the CDPH before filling out the sworn statement.

Who needs sworn statement - cdph?

1. The CDPH may require individuals or entities involved in a case or matter to submit a sworn statement. This can include:
2. - Witnesses who have relevant information
3. - Parties involved in legal proceedings
4. - Applicants for licenses or certificates
5. - Individuals involved in administrative hearings
6. It is recommended to consult the CDPH or the specific case requirements to determine if a sworn statement is necessary.

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What is sworn statement - cdph?

A sworn statement - CDPH is a formal declaration made under oath regarding specific information or facts required by the California Department of Public Health (CDPH). It is often used to verify compliance with health regulations.

Who is required to file sworn statement - cdph?

Individuals or entities that are regulated by the California Department of Public Health, including healthcare providers, facilities, and certain businesses involved in public health, are required to file a sworn statement.

How to fill out sworn statement - cdph?

To fill out a sworn statement - CDPH, obtain the designated form from the CDPH website, complete it with accurate information as required, and ensure it is signed in the presence of a notary or authorized official.

What is the purpose of sworn statement - cdph?

The purpose of a sworn statement - CDPH is to provide a legally binding assurance of truthfulness concerning information related to compliance with public health laws and regulations.

What information must be reported on sworn statement - cdph?

The sworn statement - CDPH typically requires information such as the name of the entity or individual, contact information, specific compliance details related to health regulations, and any other requested data.