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Recipient Name. MID #. Case ID #. Insurance Information. Name of Insurance Company ... Contract Administrator at (919) 715-4725. Form DMA-5055 01/2011.
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DMA-5055-IAPDF third party resource is a form used to report any third-party resources received by an individual or organization.
Any individual or organization that has received third-party resources is required to file DMA-5055-IAPDF.
DMA-5055-IAPDF third party resource can be filled out by providing information about the third-party resources received, including the amount, source, and purpose of the resources.
The purpose of DMA-5055-IAPDF third party resource is to ensure transparency and accountability in reporting any external resources received.
Information such as the amount, source, and purpose of the third-party resources must be reported on DMA-5055-IAPDF.
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