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Form CERT-42 Report of Change: Provider Agency Information - Alaska
What Is Form CERT-42?
This is a legal form that was released by the Alaska Department of Health and Social Services - a government authority operating within Alaska. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the CERT-42 form?A: The CERT-42 form is the Report of Change: Provider Agency Information form.
Q: What is the purpose of the CERT-42 form?A: The purpose of the CERT-42 form is to report changes in provider agency information in Alaska.
Q: Who needs to fill out the CERT-42 form?A: Provider agencies in Alaska are required to fill out the CERT-42 form.
Q: What changes can be reported on the CERT-42 form?A: The CERT-42 form can be used to report changes in provider agency name, address, contact information, and other relevant details.
Q: Is there a deadline for submitting the CERT-42 form?A: The deadline for submitting the CERT-42 form may vary, so it is important to check the instructions provided with the form or contact the Alaska Department of Health and Social Services for more information.
Form Details:
- Released on May 12, 2020;
- The latest edition provided by the Alaska Department of Health and 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 CERT-42 by clicking the link below or browse more documents and templates provided by the Alaska Department of Health and Social Services.
Download Form CERT-42 Report of Change: Provider Agency Information - Alaska
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