Form LIC404 Financial Information Release and Verification - California

Form LIC404 Financial Information Release and Verification - California

What Is Form LIC404?

This is a legal form that was released by the California Department of Social Services - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form LIC404?
A: Form LIC404 is the Financial Information Release and Verification form used in California.

Q: What is the purpose of Form LIC404?
A: The purpose of Form LIC404 is to authorize the release of financial information for a specified individual.

Q: Who needs to fill out Form LIC404?
A: Individuals who wish to authorize the release of their financial information in California need to fill out Form LIC404.

Q: What information is required on Form LIC404?
A: Form LIC404 requires personal information including the individual's name, address, social security number, and the purpose for which the information is being released.

Q: Is there a fee for submitting Form LIC404?
A: There is no fee for submitting Form LIC404.

Q: How long does it take to process Form LIC404?
A: The processing time for Form LIC404 may vary, but it is typically processed within a few weeks.

Q: Can I revoke the authorization provided in Form LIC404?
A: Yes, you can revoke the authorization provided in Form LIC404 by sending a written request to the California Department of Insurance.

Q: Are there any alternatives to Form LIC404?
A: Yes, individuals may use alternative forms or documents to authorize the release of financial information, but it is recommended to use Form LIC404 as it is specifically designed for this purpose.

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Form Details:

  • Released on July 1, 1999;
  • The latest edition provided by the California Department of Social Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form LIC404 by clicking the link below or browse more documents and templates provided by the California Department of Social Services.

Download Form LIC404 Financial Information Release and Verification - California

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  • Form LIC404 Financial Information Release and Verification - California, Page 1
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