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Patient Name: D.O.I./ D.O.B. Claim / Ins./ Pt ID # Date of Visit /Exam APPLICATION FOR TREATMENT ALL information you supply is CONFIDENTIAL. We comply with all federal privacy standards. Please print

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What is insmcli pi 3rd partytoshrdshp?

insmcli pi 3rd partytoshrdshp is a form used to disclose any third-party funding or support received by a political candidate or officeholder.

Who is required to file insmcli pi 3rd partytoshrdshp?

Political candidates or officeholders who receive third-party funding or support are required to file insmcli pi 3rd partytoshrdshp.

How to fill out insmcli pi 3rd partytoshrdshp?

To fill out insmcli pi 3rd partytoshrdshp, candidates or officeholders must provide detailed information about the third-party funding or support they have received.

What is the purpose of insmcli pi 3rd partytoshrdshp?

The purpose of insmcli pi 3rd partytoshrdshp is to increase transparency and accountability in political financing.

What information must be reported on insmcli pi 3rd partytoshrdshp?

Candidates or officeholders must report the source of the third-party funding or support, the amount received, and any terms or conditions attached to it on insmcli pi 3rd partytoshrdshp.

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