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COMMONWEALTH OF KENTUCKY DEPARTMENT OF INSURANCE 215 WEST MAIN STREET/P.O. BOX 517 FRANKFORT, KENTUCKY 40602 5025646082 FAX 5025644604APPLICATION FOR ORIGINAL CERTIFICATE OF AUTHORITY FOR HMO/LSO**Federal
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Step 1: Obtain the application form for the original certificate from the issuing authority.
02
Step 2: Read the instructions on the application form carefully to ensure you meet the eligibility criteria.
03
Step 3: Fill out all the required personal information accurately, such as your full name, date of birth, and contact details.
04
Step 4: Provide any additional information or documents that may be required, such as proof of identification or previous certificates.
05
Step 5: Pay the necessary application fee, if applicable, and attach the payment receipt to the application form.
06
Step 6: Review the completed application form to ensure all information is correct and all necessary documents are attached.
07
Step 7: Submit the application form along with the supporting documents to the issuing authority either in person or by mail.
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Step 8: Wait for the processing of your application and follow up with the issuing authority if necessary.
09
Step 9: Once processed, collect the original certificate from the issuing authority or arrange for its delivery, as per their instructions.

Who needs application for original certificate?

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Anyone who requires an original certificate for various purposes, such as educational institutions, employers, government agencies, or individuals seeking personal verification.
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An application for original certificate is a formal request submitted to obtain a first-time certificate, which is often required for legal, educational, or professional purposes.
Individuals or entities seeking to obtain an original certificate for legal, identification, or other official purposes are required to file this application.
To fill out the application, provide personal details, attach necessary documentation, and ensure all required fields are completed accurately according to the guidelines provided by the issuing authority.
The purpose of the application is to formally request the issuance of an original certificate, which serves as an official record or validation of a person's credentials, status, or rights.
Typically, the application must include the applicant's personal information, purpose of the certificate, relevant dates, and any specific details required by the issuing authority.
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