Blank Mississippi 297 E Form

When filling out the Mississippi 297 E form, it’s essential to follow certain guidelines to ensure a smooth application process. Here are six key do's and don'ts to keep in mind:

• Do provide accurate information for all required fields, including the name of the facility, address, and contact details.
• Do check the appropriate boxes to indicate the type of owner (e.g., Association, Corporation, Individual, Partnership).
• Do ensure that the facility manager's contact information is complete and correct to facilitate communication.
• Don't leave any required fields blank; incomplete forms can delay the application process.
• Don't forget to sign and date the application. An unsigned application may be rejected.
• Don't submit the form without reviewing it for errors or omissions, as this could lead to complications later.

Detailed Instructions for Using Mississippi 297 E

After completing the Mississippi 297 E form, you will submit it to the appropriate health department. They will review your application and schedule an inspection. Make sure all information is accurate to avoid delays in processing.

1. Begin by entering the Name of Facility at the top of the form.
2. Fill in the Facility ID Number, Physical Address, and PIN Number.
3. Provide the City, State, and Zip Code for the physical address.
4. If the mailing address is different, fill in the Mailing Address section.
5. Enter the Facility Phone Number and PHPriority.
6. Repeat the City, State, and Zip Code for the mailing address.
7. Write the Facility Manager Name, Email, and Fax Number.
8. Indicate the type of owner by checking the appropriate box: Association, Corporation, Individual, Partnership, or Other.
9. Fill in the Owner Name and Owner/Designee Contact Info.
10. Provide the Address and Phone Number/Cell for the owner or designee.
11. If applicable, fill in the Corporate Supervisor information.
12. Indicate if the facility is Smoke Free by checking Yes or No.
13. Sign and date the application where indicated as Applicant Name/Signature.
14. Provide your Address, Email, and Phone Number again at the bottom.
15. For health department use, leave the sections for Application Approved Date and Signature blank.
16. Check the box to indicate if the facility is a New, Remodel, or Conversion.
17. Leave space for the Plan Review Approved Date and Signature for health department use.

• Misconception 1: The Mississippi 297 E form is only for new facilities.

This form can be used for various purposes, including remodels and conversions, not just new applications.

• Misconception 2: Only corporations can apply using this form.

The form accommodates various ownership types, including individuals, partnerships, and associations.

• Misconception 3: Submitting the form guarantees a permit will be issued.

Approval is contingent upon meeting all health regulations and passing the inspection by the Department of Health.

• Misconception 4: The form does not require any additional documentation.

Applicants may need to provide supporting documents to demonstrate compliance with health regulations.

• Misconception 5: The inspection process is optional after submitting the form.

An inspection is mandatory for the issuance of a permit, ensuring that the facility meets health standards.

• Misconception 6: Once a permit is issued, it cannot be revoked.

Permits can be suspended or revoked at any time if the regulatory authority finds just cause.

• Misconception 7: The form must be filled out by the facility owner only.

A designee can complete the form, but the owner must still sign it to affirm responsibility.