Form IOCI17-149 Renewal Notice / Child Support / Personal History Statement - Emergency Medical Services (EMS) Systems - Illinois

Form IOCI17-149 Renewal Notice / Child Support / Personal History Statement - Emergency Medical Services (EMS) Systems - Illinois

What Is Form IOCI17-149?

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

FAQ

Q: What is IOCI17-149?A: IOCI17-149 is the form for Renewal Notice/Child Support/Personal History Statement for Emergency Medical Services (EMS) Systems in Illinois.

Q: What is the purpose of IOCI17-149?A: The purpose of IOCI17-149 is to renew the license for emergency medical service providers in Illinois and to gather personal history information for background checks.

Q: Who needs to fill out IOCI17-149?A: Emergency medical service providers in Illinois need to fill out IOCI17-149 for license renewal and background checks.

Q: What information does IOCI17-149 require?A: IOCI17-149 requires personal history information, employment history, child support compliance, and other relevant details for background checks.

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Form Details:

  • Released on November 1, 2016;
  • The latest edition provided by the Illinois Department of Public Health;
  • 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 IOCI17-149 by clicking the link below or browse more documents and templates provided by the Illinois Department of Public Health.

Download Form IOCI17-149 Renewal Notice / Child Support / Personal History Statement - Emergency Medical Services (EMS) Systems - Illinois

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