Application for registration - Form, fee, and accompanying documents

(a) An application for registration as a provider must be in a form prescribed by the administrator. (b) Subject to adjustment of dollar amounts pursuant to § 47-18-5532(f) , an application for registration as a provider must be accompanied by: (1) The fee established by the administrator; (2) The bond required by § 47-18-5513 ; (3) Identification of all trust accounts required by § 47-18-5522 and an irrevocable consent authorizing the administrator to review and examine the trust accounts; (4) Evidence of insurance in the amount of two hundred fifty thousand dollars ($250,000): (A) Against the risks of dishonesty, fraud, theft and other misconduct on the part of the applicant or a director, employee or agent of the applicant; (B) Issued by an insurance company authorized to do business in this state and rated at least "A" or equivalent by a nationally recognized rating organization approved by the administrator; (C) With a deductible not exceeding five thousand dollars ($5,000); (D) Payable for the benefit of the applicant, this state and individuals who are residents of this state, as their interests may appear; and (E) Not subject to cancellation by the applicant or the insurer until sixty (60) days after written notice has been given to the administrator; (5) A record consenting to the jurisdiction of this state containing: (A) The name, business address and other contact information of its registered agent in this state for purposes of service of process; or (B) The appointment of the administrator as agent of the provider for purposes of service of process; and (6) If the applicant is exempt from taxation under the Internal Revenue Code, 26 U.S.C. § 501 , evidence of that status. Acts 2009, ch. 469, § 1.

(a) An application for registration as a provider must be in a form prescribed by the administrator.

(b) Subject to adjustment of dollar amounts pursuant to § 47-18-5532(f) , an application for registration as a provider must be accompanied by: (1) The fee established by the administrator; (2) The bond required by § 47-18-5513 ; (3) Identification of all trust accounts required by § 47-18-5522 and an irrevocable consent authorizing the administrator to review and examine the trust accounts; (4) Evidence of insurance in the amount of two hundred fifty thousand dollars ($250,000): (A) Against the risks of dishonesty, fraud, theft and other misconduct on the part of the applicant or a director, employee or agent of the applicant; (B) Issued by an insurance company authorized to do business in this state and rated at least "A" or equivalent by a nationally recognized rating organization approved by the administrator; (C) With a deductible not exceeding five thousand dollars ($5,000); (D) Payable for the benefit of the applicant, this state and individuals who are residents of this state, as their interests may appear; and (E) Not subject to cancellation by the applicant or the insurer until sixty (60) days after written notice has been given to the administrator; (5) A record consenting to the jurisdiction of this state containing: (A) The name, business address and other contact information of its registered agent in this state for purposes of service of process; or (B) The appointment of the administrator as agent of the provider for purposes of service of process; and (6) If the applicant is exempt from taxation under the Internal Revenue Code, 26 U.S.C. § 501 , evidence of that status.

(1) The fee established by the administrator;

(2) The bond required by § 47-18-5513 ;

(3) Identification of all trust accounts required by § 47-18-5522 and an irrevocable consent authorizing the administrator to review and examine the trust accounts;

s of service of process; and (6) If the applicant is exempt from taxation under the Internal Revenue Code, 26 U.S.C. § 501 , evidence of that status.

(1) The fee established by the administrator;

(2) The bond required by § 47-18-5513 ;

(3) Identification of all trust accounts required by § 47-18-5522 and an irrevocable consent authorizing the administrator to review and examine the trust accounts;

(4) Evidence of insurance in the amount of two hundred fifty thousand dollars ($250,000): (A) Against the risks of dishonesty, fraud, theft and other misconduct on the part of the applicant or a director, employee or agent of the applicant; (B) Issued by an insurance company authorized to do business in this state and rated at least "A" or equivalent by a nationally recognized rating organization approved by the administrator; (C) With a deductible not exceeding five thousand dollars ($5,000); (D) Payable for the benefit of the applicant, this state and individuals who are residents of this state, as their interests may appear; and (E) Not subject to cancellation by the applicant or the insurer until sixty (60) days after written notice has been given to the administrator;

(A) Against the risks of dishonesty, fraud, theft and other misconduct on the part of the applicant or a director, employee or agent of the applicant;

(B) Issued by an insurance company authorized to do business in this state and rated at least "A" or equivalent by a nationally recognized rating organization approved by the administrator;

(C) With a deductible not exceeding five thousand dollars ($5,000);

(D) Payable for the benefit of the applicant, this state and individuals who are residents of this state, as their interests may appear; and

(E) Not subject to cancellation by the applicant or the insurer until sixty (60) days after written notice has been given to the administrator;

(5) A record consenting to the jurisdiction of this state containing: (A) The name, business address and other contact information of its registered agent in this state for purposes of service of process; or (B) The appointment of the administrator as agent of the provider for purposes of service of process; and

(A) The name, business address and other contact information of its registered agent in this state for purposes of service of process; or

(B) The appointment of the administrator as agent of the provider for purposes of service of process; and

(6) If the applicant is exempt from taxation under the Internal Revenue Code, 26 U.S.C. § 501 , evidence of that status.

Acts 2009, ch. 469, § 1.