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Name: Fillable Online Attestation of Compliance - Employer Fax Email Print - pdfFiller
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This document is an attestation form that employers are required to submit annually to confirm compliance with the background screening provisions set forth in chapter 435 and section 430.0402 of the Florida Statutes. It defines the responsibilities of employers, including Area Agencies on Aging, Lead Agencies, and Service Providers, regarding background screenings for employees and volunteers providing direct services to the elderly.

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How to fill out doea form 235

01

Obtain DOEA Form 235 from the official website or designated office.

02

Read the instructions provided with the form to understand the requirements.

03

Fill out the personal information section, including your name, address, and contact details.

04

Provide the necessary details related to your employment or intended purpose for the form.

05

Attach any required documentation or supporting materials as specified in the instructions.

06

Review the completed form for accuracy and completeness.

07

Sign and date the form in the designated area.

08

Submit the form via the specified method (in-person, mail, or online), as per the instructions.

Who needs doea form 235?

01

Individuals applying for a specific program or benefit associated with DOEA.

02

Agencies or organizations requiring documentation for elderly or disability services.

03

Healthcare providers needing to confirm eligibility for certain services.

04

Users seeking assistance or information from the Department of Elder Affairs.

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What is doea form 235?

DOEA Form 235 is a specific document used for reporting certain information required by the Department of Elder Affairs.

Who is required to file doea form 235?

Organizations and individuals who are involved in activities regulated by the Department of Elder Affairs must file DOEA Form 235.

How to fill out doea form 235?

To fill out DOEA Form 235, individuals must provide accurate information as requested in the form sections, ensuring all fields are completed and any necessary supporting documents are attached.

What is the purpose of doea form 235?

The purpose of DOEA Form 235 is to collect and verify information related to services provided to the elderly, ensuring compliance with state regulations.

What information must be reported on doea form 235?

DOEA Form 235 requires reporting details such as the service provider's name, address, type of services offered, and relevant financial information.

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