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AGENCY NAME: FEDERAL EMPLOYER ID #: VENDOR ID#: DSO: AGENCY CONTACT PERSON: PHONE# Rate Code: 4481MONTH / YEAR OF SERVICE: Initial claims submitted 10/01/13 or after for services more than 3 months
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The agency name federal employer is the name of the federal government entity that employs the individual.
Individuals who are employed by a federal government agency are required to report their agency name federal employer.
The agency name federal employer can usually be found on your paystub or by contacting your HR department.
The purpose of reporting the agency name federal employer is to provide information on where the individual is employed by the federal government.
The agency name federal employer must include the full name of the federal government entity that employs the individual.
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