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Get the free Small Employer Company Name and/or Ownership Change Form - selecthealth

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P.O. Box 30192 Salt Lake City, UT 84130-0192 801-442-5038/800-538-5038 select health.org Small Employer Company Name and/or Ownership Change Form Date: Current Name of Company: Telehealth Group #:
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Small employer company name refers to the legal name or registered name of a small business entity.
Small employer company name needs to be filed by small businesses or employers.
To fill out the small employer company name, you need to provide the legal or registered name of your small business.
The purpose of the small employer company name is to identify and differentiate the small business entity.
The information to be reported on the small employer company name includes the legal or registered name of the small business.
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