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Send completed form to: Service Benefit Plan Attn: Reconsideration P.O. Box 52080 Phoenix, AZ 850722080 FAX: 18002735357 Formulary Tier Exception Member Request Form CARDHOLDER COMPLETES If you are

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3. Double-check your entries for any errors or omissions. It's important to ensure the form is filled out correctly.
4. If there are any attachments or additional documents required, make sure to include them with the completed form.
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8. Choose the appropriate method of sending the completed form. This could be through email, regular mail, fax, or an online submission portal.
9. If sending the form electronically, ensure that the file is in the required format (PDF, Word document, etc.).
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11. If necessary, keep a copy of the completed form for your records.
12. Follow up with the recipient if you haven't received any confirmation of receipt within a reasonable period of time.

The completed form typically needs to be sent to the relevant party or organization that requested the information. This could be an employer, a government agency, a school admissions office, a financial institution, or any other entity requiring specific information. It's important to make sure you know exactly who needs to receive the form in order to ensure it reaches the correct destination.

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How to fill out send completed form to?

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