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1000© Addendum EMERGENCY MEDICAL SERVICES LICENSURE APPLICATION GEORGIA OFFICE OF EMERGENCY MEDICAL SERVICES AND TRAUMA GEMS 1000 INSURANCE INFORMATION Name of Service(s): License Number(s): License

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What is 1000c addendum?

The 1000c addendum is a supplemental form to provide additional information related to a primary form.

Who is required to file 1000c addendum?

Entities or individuals specified in the instructions of the primary form are required to file the 1000c addendum.

How to fill out 1000c addendum?

The 1000c addendum should be completed by providing the requested information in the designated fields.

What is the purpose of 1000c addendum?

The purpose of the 1000c addendum is to ensure all relevant information is disclosed in relation to the primary form.

What information must be reported on 1000c addendum?

The 1000c addendum typically requires specific details or data points as outlined in the form instructions.

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