Clean Hands Request Form

The DC Department of Consumer and Regulatory Affairs (DCRA) requires a Clean Hands Certification prior to the issuance of certain licenses and permits.

This certification may be signed on behalf of the university only by the Executive Vice President and CFO or his designee.

The Compliance and Privacy Office facilitates the process of obtaining a signature, which requires polling a number of units within the university in order to obtain the necessary information.

Please complete the form at least five business days in advance of your DCRA submission date. If you have questions regarding this form, please contact us at 202-994-3386 or [email protected].

We will contact this person if we are unable to reach you.
Signed Form Due Date *
Is this for a university-owned entity that operates under a different name? *