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For office use only: Group #: Effective Date: Benefit Code: By: ENROLLMENT×CHANGE AND TERMINATION FORM PLEASE PRINT (26 50 Eligible Employees) Plan Selected: HMO PPO Please check as appropriate:
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How to fill out for office use only:

01
Locate the section on the form that is designated for office use only. This section is typically labeled or indicated clearly.
02
Read any instructions or guidelines provided to ensure you understand the purpose and requirements of the office use only section.
03
Fill in the necessary information in the designated fields or spaces provided. This may include details such as the date, time, name of the office or department, and any other relevant information.
04
Double-check your entries for accuracy and completeness. Make sure all the required information is provided and there are no errors or omissions.
05
If there are any additional instructions or specific actions to be taken in the office use only section, follow them accordingly.
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Once you have completed filling out the office use only section, review the rest of the form to ensure you have provided all the required information in other sections as well.
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Finally, submit the form as instructed, keeping in mind that the office use only section should not be disclosed or shared with anyone who is not authorized to access or utilize that information.

Who needs for office use only:

01
Generally, forms that have sections labeled for office use only are intended for internal use within an organization or department.
02
Employees or staff members who are responsible for processing or handling the forms often need the office use only section. This could include administrative personnel, supervisors, or other authorized individuals who require the information for official purposes.
03
The office use only section may contain sensitive or confidential information that is not intended to be seen or used by the form submitter or external parties. Therefore, it is the responsibility of the office or department to ensure the confidentiality and security of the information provided in this section.
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For office use only is a designation on documents or forms that indicates the information is intended only for internal office purposes and should not be disclosed to the public or external parties.
Any personnel or entity that handles sensitive information or documents may be required to designate certain materials as for office use only.
To fill out for office use only, simply mark or stamp the document with the designation 'For office use only' in a visible location.
The purpose of for office use only is to prevent sensitive information from being shared outside of the organization and to maintain the confidentiality of certain documents or data.
Any confidential or sensitive information that is not intended for public knowledge must be reported as for office use only.
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