LIC 9269 Form 5-5: Annual Reserve Certification

The LIC 9269 Form 5-5 is used by facilities regulated by the California Department of Social Services to certify their annual reserves. This form verifies that the facility has met the required reserve amounts based on applicable regulations and guidelines. It ensures compliance with financial requirements and promotes transparency in reporting. By completing this form, facility operators provide assurance that they have maintained appropriate reserve levels, demonstrating fiscal responsibility and accountability.