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STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING SURETY BOND (Original sent to Regional Office) Applicant/Licensee Name: Address:
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Original sent to regional is a formal document submitted to the appropriate regional authority containing original documents or information.
Any individual or organization required by law or regulations to submit specific documents or information to the regional authority.
Original sent to regional should be filled out according to the instructions provided by the regional authority, ensuring that all required information is accurate and complete.
The purpose of original sent to regional is to ensure that the regional authority receives necessary documents or information in a timely manner.
The specific information to be reported on original sent to regional will vary depending on the requirements of the regional authority.
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Relevant keywords

CALIFORNIA Licensee LIC CALIFORNIAHEALTH severally successors SURETY aggregate assigns LICENSING jointly certify Applicant respective heirs attachments applicants specify licenses exceed cancellation beneficiary faithfully thereby accordance Rehabilitatio

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