Form LIC 9271. Form 9-1: Calculation Of Refund Reserve Amount - California

Form LIC 9271 is used in California by care facilities, particularly Continuing Care Retirement Communities (CCRCs), to calculate the refund reserve amount. This form is completed on an annual basis by the CCRC 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 refund reserve amount based on specific factors such as the number of residents, types of contracts, refundable portions, and any applicable formulas or guidance provided by the California Department of Social Services. Important fields include resident information, contract details, refundable amounts, and the resulting reserve calculation.

An application example of this form would involve a CCRC using Form LIC 9271 to calculate and report the refund reserve amount to the California Department of Social Services. The CCRC operator or administrator would gather the necessary resident and contract information, apply the relevant calculations based on the provided instructions, and accurately fill out the form. By completing this form, CCRCs ensure compliance with refund reserve requirements and provide transparency regarding their financial obligations to residents.

Alternative forms: No direct alternative form is specified for Form LIC 9271 since it is specifically designed for calculating the refund reserve amount. However, CCRCs may need to consult other financial records and documentation related to their contracts and refundable amounts when completing this form. Additionally, a related form is Form LIC 9269, Form 5-5: Annual Reserve Certification - California, which includes a section for reporting the refund reserve amount as part of the overall certification process. The main difference lies in the focus of each form, with Form LIC 9271 specifically addressing the calculation of the refund reserve amount, while Form LIC 9269 encompasses a broader certification of various reserves.