(b) A complete application includes without limitation:

1. (1) Documentation demonstrating the applicant’s entire ownership, including without limitation all information on the applicant’s governing body as well as financial and business interests;
2. (2) Documentation of the applicant’s management, including without limitation the management structure and members of the management team;
3. (3) Documentation of the applicant’s current contractors and the contractors that the applicant intends to use as part of providing early intervention services;
4. (4) Documentation of all required state and national criminal background checks for all employees and contractors;
5. (5) Documentation of all required drug screens, registry checks, and searches for employees and contractors;
6. (6) Documentation of active Medicaid provider number, if providing developmental therapy (provider type 78) Medicaid developmental rehabilitation services (DRS) required in order to bill Medicaid for developmental therapy services;
7. (7) Secretary of State registration, if using a doing business as (dba) name;
8. (8) IRS SS4 approval letter, (501C3 if the facility is nonprofit);
9. (9) Fiscal year end date (if not provided, it will default to December);
10. (10) Disclosure of Significant Business Transactions form DMS 689;
11. (11) Ownership and Conviction Disclosure form DMS 675; and
12. (12) All other documentation or other information requested by the Department of Education.