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Keep a copy of this completed form for your personal records. Authorization to Release. Personal Information. Fax Completed Form to: 1-402-978-3728.
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What is fax completed form to?
Fax completed form to the designated recipient.
Who is required to file fax completed form to?
The fax completed form must be filed by the individual or entity specified by the instructions.
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Fill out the necessary information on the form and then fax it to the designated recipient.
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The purpose of fax completed form is to provide timely and accurate information to the recipient.
What information must be reported on fax completed form to?
The form must include all required information as indicated in the instructions.
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