The Fact Sheet for Attorney in Fact or General Agent Form is a document of the DC Department of Licensing and Consumer Protection (DLCP), Occupational and Professional Licensing Division. The person who agrees to act as attorney-in-fact or general agent for a company completes it, giving contact details, answering a question about arrests or charges, and agreeing to accept notices for the company. If you found this page while looking into a DC business license, note that it covers this one agent document only. On FillingPDF you can fill out the form online and download or print the completed PDF; the DLCP publishes the official PDF.
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What is Fact Sheet for Attorney in Fact or General Agent Form – Washington, DC?
The Fact Sheet for Attorney in Fact or General Agent Form is a DC Department of Licensing and Consumer Protection (DLCP) form in which a person agreeing to act as attorney-in-fact or general agent for a company supplies details and accepts notices for it.
The printed form is headed Occupational and Professional Licensing Division and is titled FACT SHEET FOR ATTORNEY-IN-FACT OR GENERAL AGENT. It collects:
- the agent's name and date of birth (DOB);
- the agent's home address, home phone, business phone and business address;
- an answer to whether the agent has ever been arrested or charged with any offense other than parking violations in the District of Columbia or elsewhere, with an explanation if the answer is yes;
- the agent's agreement to act for a named company and to accept service of all notices of any action to be taken with respect to that company;
- the agent's signature, with a block for a notary public, a seal and the date the notary's commission expires.
The form also carries a notice headed LOCAL AGENT FORM. It says the document is completed by the person accepting responsibility for receiving notifications, security related materials and any business related to the agency. This page covers that single document, not a license application.
Who needs to file Fact Sheet for Attorney in Fact or General Agent Form – Washington, DC?
The person who agrees to be the attorney-in-fact or general agent for a company completes this form. The notice printed on it says the document is to be completed by the person accepting the responsibility for receiving notifications, security related materials and any business related to the agency.
Conditions printed on the form:
- The agent must either reside or presently be employed in the District of Columbia.
- Answering services and law firms are not acceptable, unless someone within the organization agrees to be the responsible person.
- The agent agrees to accept service of all notices of any action to be taken with respect to the company named on the form.
The form does not say who may sign on behalf of the agent, and it names no representative who may complete it in the agent's place. The company itself is only named in the agreement line; the person who signs is the agent.
When to file Fact Sheet for Attorney in Fact or General Agent Form – Washington, DC
The triggering event is a person's agreement to act as attorney-in-fact or general agent for a company, because the form records that agreement and the agent's acceptance of notices for the company. The form prints no due date, renewal cycle or validity period of its own. For questions about timing or about the process this fact sheet belongs to, the form gives the DLCP Helpline at (202) 671-4500 and the website dlcp.dc.gov.
How to fill out Fact Sheet for Attorney in Fact or General Agent Form – Washington, DC
Confirm the agent qualifies
Before you start, check that the person accepting the responsibility resides or is presently employed in the District of Columbia. An answering service or law firm is acceptable only if someone within the organization agrees to be the responsible person.
Enter name and date of birth
In the top lines, write the agent's name and DOB.
Enter home contact details
Fill in Home Address and Home Phone for the agent.
Enter business contact details
Fill in Business Phone and Business Address for the agent.
Answer the arrest question
Answer whether you have ever been arrested or charged with any offense other than parking violations in the District of Columbia or elsewhere. If yes, explain in the lines below the question.
Name the company in the agreement
In the sentence beginning "I hereby agree to be the attorney-in-fact/general agent on behalf of", write the name of the company. The sentence also states that you agree to accept service of all notices of any action to be taken with respect to that company.
Sign the agreement
The agent signs on the Signature line under the agreement.
Complete the notary block
The notary public block has lines for the notary's name, a (SEAL) space and MY COMMISSION EXPIRES. The notary completes these; leave room for them on the printed page.
Review and download the completed PDF
Check that the name, DOB, addresses, phone numbers, company name and explanation (if any) are complete. Download or print the completed PDF from FillingPDF, then sign and have it notarized as the form provides.
How to submit Fact Sheet for Attorney in Fact or General Agent Form – Washington, DC
The form itself prints no mailing address, portal, fax number or appointment rule, so it names no submission channel. What it does give is the contact point of the agency that publishes it: DC Department of Licensing and Consumer Protection, Helpline (202) 671-4500, dlcp.dc.gov.
Before you send or deliver the completed form, check that it carries the agent's signature and the notary public block (notary name, seal and commission expiration date), because those blocks are part of the printed form. Ask the DLCP Helpline how and where to deliver it, and whether it must accompany another filing for the company. FillingPDF lets you fill out and download the PDF; submission follows the agency's channels.
Common mistakes to avoid
- Having someone other than the person accepting the responsibility complete the form; the notice on it says that person completes it.
- Naming an answering service or law firm as the agent when no one within the organization has agreed to be the responsible person.
- Listing an agent who neither resides nor is presently employed in the District of Columbia.
- Answering yes to the arrest or charge question without writing an explanation in the lines provided.
- Leaving the company name blank in the sentence beginning "I hereby agree to be the attorney-in-fact/general agent on behalf of".
- Sending the form without the agent's signature.
- Leaving the notary public block incomplete: the notary name, the seal and the commission expiration date.
- Counting parking violations as offenses in the arrest question; the form excludes them.
Frequently asked questions
What is the Fact Sheet for Attorney-in-Fact or General Agent?
It is a DLCP document, issued through the Occupational and Professional Licensing Division, that the person agreeing to act as attorney-in-fact or general agent for a company completes. It records the agent's details and arrest or charge history, and the agreement to accept notices for the company.
Who has to complete the Fact Sheet for Attorney-in-Fact or General Agent?
The person accepting the responsibility for receiving notifications, security related materials and any business related to the agency completes it. That person agrees on the form to be the attorney-in-fact or general agent for the named company.
Does the agent have to live in Washington, DC?
The agent must either reside or presently be employed in the District of Columbia. The form does not require both: one of the two is enough, according to the notice printed on it.
Can a law firm or answering service be the general agent?
Not by itself. The form says answering services and law firms are not acceptable, unless someone within the organization agrees to be the responsible person. That individual is the one who completes and signs the form.
Do I have to disclose arrests on this form?
The form asks whether you have ever been arrested or charged with any offense other than parking violations in the District of Columbia or elsewhere. If your answer is yes, you must explain in the lines provided.
Does the form need to be notarized?
The printed form includes a notary public block with the notary's name, a seal space and the commission expiration date, below the agent's signature. Ask the DLCP Helpline at (202) 671-4500 how the notary block applies to your filing.
Is this form a DC business license application?
No. It is a fact sheet completed by the person who agrees to act as attorney-in-fact or general agent for a company. For questions about a DC business license or what else accompanies the form, contact the DLCP Helpline at (202) 671-4500 or dlcp.dc.gov.
Can I fill out this fact sheet online on FillingPDF?
Yes. You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service, not affiliated with DLCP, and it does not file or send the form; you deliver it through the agency's channels.
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