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APPLICATION FOR PAYMENT OF ATTORNEY FEES under the MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES CODE Adult only Please print or type information Form No. NCAMH1 PAYEE: VENDOR NO. Last Name, First
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Administrative office of form is a document used to report the address and contact information of the primary office responsible for overseeing administrative tasks.
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Information such as office address, phone number, email address, and the name of the responsible personnel must be reported on administrative office of form.
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