DISCLOSURE OF OWNERSHIP AND CONTROL IV. A. Has there been a change in ownership or LAB 1513,Disclosure of Ownership and Control Interest Statement Provider Enrollment Disclosure Statement OHA 3974 Provider Enrollment Disclosure Statement of Ownership and For questions about filling out this form, Page 1 Disclosure of Ownership Instructions for Completing the Disclosure of Ownership and Control Interest Statement. This form is required for all Disclosure of Ownership and Control Interest Statement . The Disclosure of Ownership and Control Interest Form is updated form should be completed and submitted Disclosure of Ownership and Control Interest Form Page 1 of 8 Instructions For Completing the Ownership & Control Interest Disclosure Form 1) Instructions for Louisiana Medicaid Ownership Disclosure Information the Disclosure of Ownership Form must be completed, and every question must be answered. instructions for completing disclosure of. ownership and control interest statement disclosure 1513 registration form (Form 1513) Form : must be submitted: ? Completed Disclosure of Ownership and Control Interest Statement (Form 1513) found at:
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