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Supplemental CON Application Form Transfer of Ownership/Sale of Hospital Conn. Gen. Stat. 19a486 and 19a638(a)(2) Applicant:Project Name:OHS Version 3/29/19 iAffidavitApplicant: Project Title: I,
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How to fill out 19a-486 and 19a-638a2

How to fill out 19a-486 and 19a-638a2
01
To fill out the 19a-486 form, follow these steps:
1. Start by entering the heading '19a-486' at the top of the form.
02
Provide your personal information, including your name, address, phone number, and email address.
03
Indicate the date on which you are filling out the form.
04
Next, fill in the details regarding the type of 19A exemption you are applying for.
05
Include any additional information or explanations as required by the form.
06
Review the completed form to ensure accuracy and completeness.
07
Sign and date the form at the designated space.
08
To fill out the 19a-638a2 form, follow these steps:
09
Begin by entering the title '19a-638a2' at the top of the form.
10
Enter your personal information, including your name, address, contact details, and date.
11
Indicate the specific details of the exemption for which you are applying.
12
Include any additional information or explanations as required.
13
Carefully review the completed form to ensure all information is accurate.
14
Sign and date the form at the given space.
Who needs 19a-486 and 19a-638a2?
01
The 19a-486 form is needed by individuals or organizations who are seeking an exemption under section 19A of a particular statute or regulation.
02
The 19a-638a2 form is required by individuals, businesses, or entities who are applying for a specific type of exemption as outlined in section 19A-638a2 of a particular law or regulation.
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What is 19a-486 and 19a-638a2?
19a-486 and 19a-638a2 are forms used for filing specific reports related to regulatory requirements in certain jurisdictions, often pertaining to healthcare services and utility companies.
Who is required to file 19a-486 and 19a-638a2?
Entities that provide certain regulated services, such as healthcare providers or utility companies, are required to file these forms.
How to fill out 19a-486 and 19a-638a2?
To fill out 19a-486 and 19a-638a2, individuals or entities must follow the instructions provided with the forms, ensuring that all required information is accurately completed and supported by any necessary documentation.
What is the purpose of 19a-486 and 19a-638a2?
The purpose of 19a-486 and 19a-638a2 is to gather data related to service provision, compliance, and regulatory oversight, ensuring transparency and accountability within the impacted industries.
What information must be reported on 19a-486 and 19a-638a2?
The forms typically require information such as service statistics, financial data, compliance measures, and operational details relevant to the regulatory framework.
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