Form W-265 Report of Admission or Discharge Rated Housing Facility / Residential Care Home - Connecticut

Form W-265 Report of Admission or Discharge Rated Housing Facility / Residential Care Home - Connecticut

What Is Form W-265?

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

FAQ

Q: What is Form W-265?
A: Form W-265 is a report used in Connecticut to disclose the admission or discharge of residents in a rated housing facility or residential care home.

Q: Who needs to file Form W-265?
A: Owners or operators of rated housing facilities or residential care homes in Connecticut need to file Form W-265.

Q: When should Form W-265 be filed?
A: Form W-265 should be filed within 30 days of the admission or discharge of a resident in a rated housing facility or residential care home.

Q: What information is required on Form W-265?
A: Form W-265 requires information such as the resident's name, address, social security number, admission or discharge date, and other relevant details.

Q: Are there any penalties for not filing Form W-265?
A: Failure to file Form W-265 may result in penalties or fines imposed by the Connecticut Department of Revenue Services.

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Form Details:

  • Released on August 1, 2015;
  • The latest edition provided by the Connecticut State Department of Social Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form W-265 by clicking the link below or browse more documents and templates provided by the Connecticut State Department of Social Services.

Download Form W-265 Report of Admission or Discharge Rated Housing Facility / Residential Care Home - Connecticut

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