This is a legal form that was released by the Texas Health and Human Services - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form 3604-A?
A: Form 3604-A is an Ownership Transfer Affidavit Addendum for ICF/IID (Intermediate Care Facility/Intellectual and Developmental Disability) in Texas.
Q: Who needs to fill out Form 3604-A?
A: Form 3604-A needs to be filled out by individuals or organizations transferring ownership of an ICF/IID facility in Texas.
Q: What is an ICF/IID facility?
A: ICF/IID stands for Intermediate Care Facility for Individuals with Intellectual Disabilities. It is a type of healthcare facility that provides residential care and support services to individuals with intellectual disabilities.
Q: What is the purpose of Form 3604-A?
A: The purpose of Form 3604-A is to document the transfer of ownership of an ICF/IID facility in Texas and provide the necessary information to the proper authorities.
Q: Is there a fee for filing Form 3604-A?
A: There may be a fee associated with filing Form 3604-A. It is best to check with the relevant state agency or consult the instructions for the form.
Q: Are there any deadlines for filing Form 3604-A?
A: Specific deadlines for filing Form 3604-A may vary. It is important to comply with the instructions and requirements of the relevant state agency.
Q: What should be included in Form 3604-A?
A: Form 3604-A requires information about the current and new owners of the ICF/IID facility, details of the transfer, and any required supporting documentation.
Q: What happens after Form 3604-A is submitted?
A: After Form 3604-A is submitted, the relevant state agency will review the information, process the transfer of ownership, and provide any further instructions if necessary.
Form Details:
Download a fillable version of Form 3604-A by clicking the link below or browse more documents and templates provided by the Texas Health and Human Services.