Package 2 Application for Enrollment Yes 01-Application Form B Applicant Assumed Name Certificate Yes, if 01.A-DBA Provides applicable. Applicant 01.B-Incorporation Certificate of Incorporation Yes, if Provides applicable. Applicant 01.C-LLC LLC Articles of Formation Yes, if Provides applicable. Applicant 01.D-Partnership Partnership Agreement Yes, if Provides applicable. Yes, if Insurance Acord Document currently Applicant 01.E-Insurance insured. Insurance is Provides not required at the time of application. FILE FOLDER 2: Attachments Document ELECTRONIC FILE Is Document Location NAME Document Required Yes/No Applicant 01-License DFPS Residential Yes Provides License or acceptance letter Applicant 02.A-Board Board of Directors Yes, if Provides applicable. Applicant 02.B-Org Chart Professional Organizational Yes Provides Chart Applicant 02.C-Staffing Plan Professional Staffing Plan Yes Provides Applicant 02.D-Resume/ Resumes and Professional Yes Provides Professional Licenses Licenses for Key Management Staff Applicant 02.E-Resume/ Yes, if Provides Professional Licenses applicable. Applicant 02.F-Resume/ (Label applicable additional Yes, if resumes accordingly, e.g. Provides Professional Licenses applicable. 09.G, 09.H, etc.) Applicant 03-Balance Sheet Balance Sheet Yes Provides (If in operation for one or more years) Applicant 03.A-Income and Statement of Income and Yes Provides Expense Expense
Package 2 Form B 01-Application Application for Enrollment Yes Applicant Provides 01.A-DBA Assumed Name Certificate Yes, if applicable. Applicant Provides 01.B-Incorporation Certificate of Incorporation Yes, if applicable. Applicant Provides 01.C-LLC LLC Articles of Formation Yes, if applicable. Applicant Provides 01.D-Partnership Partnership Agreement Yes, if applicable. Applicant Provides 01.E-Insurance Insurance Acord Document Yes, if currently insured. Insurance is not required at the time of application. FILE FOLDER 2: Attachments Document Location ELECTRONIC FILE NAME Document Is Document Required Yes/No Applicant Provides 01-License DFPS Residential License or acceptance letter Yes Applicant Provides 02.A-Board Board of Directors Yes, if applicable. Applicant Provides 02.B-Org Chart Professional Organizational Chart Yes Applicant Provides 02.C-Staffing Plan Professional Staffing Plan Yes Applicant Provides 02.D-Resume/ Professional Licenses Resumes and Professional Licenses for Key Management Staff (Label applicable additional resumes accordingly, e.g. 09.G, 09.H, etc.) Yes Applicant Provides 02.E-Resume/ Professional Licenses Yes, if applicable. Applicant Provides 02.F-Resume/ Professional Licenses Yes, if applicable. Applicant Provides 03-Balance Sheet Balance Sheet (If in operation for one or more years) Yes Applicant Provides 03.A-Income and Expense Statement of Income and Expense Yes