Form LIC 9267. Form 5-3: Calculation Of Long-Term Debt Reserve Amount - California

Form LIC 9267 is used in California by care facilities to calculate and report the long-term debt reserve amount. This form is completed on an annual basis by the facility operator or administrator.

The form consists of sections that require information about the facility, including its name, address, license number, and the reporting period. The main part of the form focuses on calculating the long-term debt reserve amount based on specific factors such as the outstanding long-term debt balance, the interest rate, and the term of the debt. The form provides instructions and formulas for performing the calculation accurately. Important fields include financial data related to the facility's long-term debt, interest rates, and the resulting reserve amount.

An application example of this form would involve a care facility using Form LIC 9267 to calculate and report the long-term debt reserve amount to the California Department of Social Services. The facility operator or administrator would gather the necessary financial information about the outstanding long-term debt and perform the calculations based on the provided instructions. By completing this form accurately, care facilities ensure compliance with reporting requirements and contribute to the establishment of appropriate reserves for long-term debt obligations.

Alternative forms: No direct alternative form is specified for Form LIC 9267, as it is specifically designated for calculating and reporting the long-term debt reserve amount. However, care facilities may need to consult other financial records and documentation related to their long-term debt when completing this form.