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4770 E. Cliff Ave Suite 224 Denver, Colorado 80222 (303)8843867 www.tmscenterofcolorado.comConsent for Release of Confidential InformationPatient Name: Date of Birth: I herby authorize: Covered Entity:
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4770 e is a form used for reporting certain financial transactions to the government.
Financial institutions and individuals who meet certain criteria are required to file 4770 e.
4770 e can be filled out online or submitted through traditional mail. It is important to accurately report all required information.
The purpose of 4770 e is to help the government track and prevent financial crimes such as money laundering and terrorist financing.
Information such as the name and address of the parties involved in the transaction, the amount of money exchanged, and the purpose of the transaction must be reported on 4770 e.
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