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DocuSign Envelope ID: 0D3853DC9D2F488BA29240824843EA10FORM A STATEMENT REGARDING THE ACQUISITION OF CONTROL OF OR MERGER WITH A DOMESTIC INSURERHealth Plan of Care Oregon, Inc., a subsidiary of Care
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Review the terms and conditions of the affiliation agreement thoroughly.
02
Fill in the necessary information such as names of the parties involved, effective date, and any specific terms agreed upon.
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Sign and date the agreement in the designated spaces.
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Make sure all parties have signed the agreement before submitting it.

Who needs execution version affiliation agreement?

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Any individuals or organizations entering into an affiliation or partnership agreement.
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An execution version affiliation agreement is a legal document that outlines the relationship and arrangements between parties who are affiliated with each other.
The parties involved in the affiliation agreement are required to file the execution version of the agreement.
The execution version of the affiliation agreement should be filled out with all necessary information and signatures from both parties.
The purpose of the execution version affiliation agreement is to ensure that the terms of the affiliation are clearly defined and agreed upon by all parties.
The execution version of the affiliation agreement must include details about the parties involved, the terms of the agreement, and any other relevant information.
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