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PLEASE PRINT NEATLY OverTheCounter (OTC) Reimbursement Claim Form SECTION A Participant Name: Participant Address: Participant ID: Participant DOB: Participant Phone Number: () SECTION B This claim
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How to fill out Purchase Date and Location of:

01
First, locate the field for Purchase Date on the form or document you are filling out.
02
Enter the date of the purchase in the designated area. Make sure to use the correct format as specified, such as MM/DD/YYYY or DD/MM/YYYY.
03
Next, find the field for Purchase Location on the form or document.
04
Provide the exact location or address where the purchase took place. This could be a physical store name and address or an online platform if applicable.
05
Double-check your entries for accuracy before submitting the document or form.

Who needs Purchase Date and Location of:

01
Buyers recording purchases: Individuals or businesses who need to maintain records of their purchases may require the purchase date and location information. This is common for accounting, expense tracking, or warranty purposes.
02
Insurance claims: Companies or individuals filing insurance claims may be required to provide the purchase date and location of the items being claimed.
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Legal documentation: Purchase date and location information may be necessary for legal documents, such as contracts or agreements, to establish a timeline or jurisdiction.
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Product recalls or complaints: Customers filing product recalls or complaints may need to provide the purchase date and location as proof of purchase or to help the company track down relevant information.
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