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Texas Department of Insurance, Division of Workers' Compensation 7551 Metro Center Drive, Suite 100 Austin, Texas 78744-1609 MEDICAL DISPUTE RESOLUTION FINDINGS AND DECISION PART I: GENERAL INFORMATION
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How to fill out requestors name and address?

01
Start by writing the requestor's full name. Include their first name, middle name (if applicable), and last name.
02
Next, provide the requestor's complete address. Include the house or building number, street name, city, state or province, postal or ZIP code, and country. Make sure to write the address accurately to ensure successful delivery.
03
If the requestor has a specific company or organization affiliation, include that information as well. Write the name of the company or organization, along with any additional details such as department or division.

Who needs requestors name and address?

Various individuals or entities may require the requestor's name and address. These may include but are not limited to:
01
Government agencies or departments: They often request this information for official purposes and communications.
02
Service providers: Companies or organizations may need the requestor's name and address to fulfill their services or send relevant documents.
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Legal entities: Lawyers, law firms, or legal departments may require the requestor's name and address for legal procedures or documentation.
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Business partners: In some cases, requestor's name and address may be needed by business partners for collaboration, communication, or contract purposes.
05
Educational institutions: Schools or universities may ask for the requestor's name and address for enrollment, administration, or academic purposes.
It is important to note that the specific reasons and requirements for obtaining the requestor's name and address will vary depending on the situation and the nature of the request.

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The requestor's name and address refers to the personal information of the individual or organization making a request.
The entity or individual who is making a request needs to provide their own name and address.
The requestor should fill out the relevant fields on the request form by providing their full name and complete address.
The purpose of requesting the name and address of the requestor is to ensure accurate identification and contact information for further communication or documentation purposes.
The requestor must report their full legal name and the complete address where they can be contacted.
The deadline to file the requestor's name and address in 2023 may vary depending on the specific regulations or requirements. Please refer to the official guidelines or consult with the relevant authorities for accurate information.
The penalty for late filing of the requestor's name and address may also vary depending on the governing rules and regulations. It is advisable to consult with the appropriate authorities or refer to the official guidelines for specific details.
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