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Section A — Licensing Application Forms ~25 min

HCS 309 Form Guide — Organization/Entity Ownership (California HCO)

The HCS 309 lists who owns and runs your business. It covers 10%+ owners, officers, directors or managers, and your agent. It must match your HCS 200. Sole owners do not file it.

Breaking Down the HCS 309

Have your Articles and your Operating Agreement or bylaws next to you. The HCS 309 must match your HCS 200. Terms of office must match your bylaws (HCS 281 A4).

Which part do I fill out?
  • LLC or corporation: Section I (items 1–12).
  • Partnership: Section III. List each general partner and a contact person.
  • Public agency: Section II.
  • Other groups: Section IV.
Items 1–5 — Basic facts

Name as filed with the Secretary of State. CEO or equal. Date and place filed. Your entity number.

Item 6 — Attach these
  • Your Articles and any changes.
  • Your bylaws or Operating Agreement and any changes.
  • Corporations only: the resolution that approves filing this application.
Item 7 — Office, contact, and agent

Your main office address. A contact person. Your agent for service of process and their address. Use what is on file with the Secretary of State.

Item 8 — Out-of-state or foreign business only
  • 8a: Name a California representative with an address and phone.
  • 8b: Attach proof you are registered to do business in California.
  • You also need an office in California. Keep your records there (HSC §1796.36).
Item 9 — 10% owners

List each person with 10% or more ownership, with address and percent. If someone owns through another company, attach a chart that shows each level.

These owners, and your CEO, must pass the CDSS background check (HSC §1796.33).

Items 10–12 — Directors, managers, and officers
  • Item 10: how many directors or managers, term, and how often you meet.
  • Item 11: officers (President, Vice President, Secretary, Treasurer, CEO).
  • Item 12: every director, manager, and managing member.
  • The form says LLCs without officers skip 11–12.

Common Mistakes to Avoid

  • 1Guessing your entity number or filing date. Look them up on the Secretary of State site.
  • 2Forgetting the item 6 attachments: Articles, bylaws or Operating Agreement, and (corporations) the resolution.
  • 3Out-of-state business: skipping item 8 or the proof of California registration.
  • 4Terms of office that do not match your bylaws (HCS 281 A4).

Tips

  • One person holds more than one office? Enter that name in each spot.
  • The HCS 309 says to send an update each time partners, officers, or the business changes.

What You Need to Do

  1. 1
    Verify your exact Registration Date and Entity Number on the CA Secretary of State website
  2. 2
    Complete corporate data fields above
  3. 3
    Generate, print, and sign the HCS 309
  4. 4
    Gather your Articles of Organization/Incorporation and your Operating Agreement/Bylaws to include in your final mailing packet

    HCS 309 item 6. Corporations also attach the resolution that approves this application.

  5. 5
    Out-of-state LLC or corporation: fill in item 8 and attach your California registration

    HCS 309 item 8. Skip this if you formed in California.

Information You Will Need

Have these details ready before you sit down to fill this out:

Name (As Filed with Secretary of State)
Required
Chief Executive Officer or Equivalent

For a single-member LLC, this is usually you (the Managing Member).

Required
Incorporation / Registration Date

The exact date your entity was approved by the state (found on your stamped Articles).

Required
Place of Incorporation / Registration
Required
Corporation / LLC Number
Required
7b. Agent for Service of Process (Name)

The person or registered agent company designated to receive legal mail.

Required
Agent for Service of Process (Address)

A California street address. No P.O. Boxes.

Principal Office of Business (address)
7a. Contact Person (name, title, phone)
8a. California Representative (out-of-state or foreign business only)
Primary Owner (10%+ Interest) — Full Legal Name
Required
Primary Owner — Address
Required
Primary Owner — Ownership Percentage
Required
Second Owner (10%+ Interest) — Full Legal Name

Leave blank if you are a 100% owner.

Second Owner — Address
Second Owner — Ownership Percentage
Third Owner (10%+ Interest) — Full Legal Name
Third Owner — Address
Third Owner — Ownership Percentage
Fourth Owner (10%+ Interest) — Full Legal Name

More than 4? Add them on the People page and attach a sheet (HCS 309 item 9).

Fourth Owner — Address
Fourth Owner — Ownership Percentage
10a. Number of Directors / Managers

How many people sit on your Board of Directors (Corp) or act as Managing Members (LLC)?

Required
President / Chairman
Secretary
Treasurer

Documents Needed

  • HCS 309 — Organization Structure (pre-filled)
    RequiredPDF · Max 10MB

Official Resources

Want us to handle this for you?

Our licensing team knows this form inside and out. We fill out every form, check every box, and submit the whole packet to CDSS on your behalf. You just answer a few simple questions.

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John Helmy

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John Helmy, Founder of HomeCareAtlas

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