Form LIC421D Civil Penalty Assessment - Death / Serious Bodily Injury / Physical Abuse (Asc) - California

Form LIC421D Civil Penalty Assessment - Death / Serious Bodily Injury / Physical Abuse (Asc) - California

What Is Form LIC421D?

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 the LIC421D form used for?
A: The LIC421D form is used for assessing civil penalties for death, serious bodily injury, or physical abuse in California.

Q: When is the LIC421D form required?
A: The LIC421D form is required when there is a death, serious bodily injury, or physical abuse incident that needs to be investigated and penalties need to be assessed.

Q: Who needs to fill out the LIC421D form?
A: The form is typically filled out by the relevant authorities or agencies responsible for investigating the incident and assessing civil penalties.

Q: Is the LIC421D form specific to California?
A: Yes, the LIC421D form is specific to the state of California.

Q: What are the consequences of not filling out the LIC421D form?
A: Failure to fill out the LIC421D form when required may result in legal consequences or penalties.

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Form Details:

  • Released on June 1, 2017;
  • 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 LIC421D by clicking the link below or browse more documents and templates provided by the California Department of Social Services.

Download Form LIC421D Civil Penalty Assessment - Death / Serious Bodily Injury / Physical Abuse (Asc) - California

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