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Member Change Form Submit completed application to: Common Ground Healthcare Cooperative PO Box 33837 Indianapolis IN 462030837MEMBER ID # GROUP NUMBER I. Applicant Information FIRST NAMESAKE ADDRESS
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How to fill out member change form
How to fill out member change form
01
Obtain a copy of the member change form from the concerned department or organization.
02
Fill in the relevant details of the member who needs to be changed, such as their name, contact information, and any other required information.
03
Indicate the reason for the member change, whether it's due to resignation, transfer, or any other circumstances.
04
Attach any supporting documents or proofs, if necessary, such as a resignation letter or transfer request.
05
Review the filled form for accuracy and completeness.
06
Submit the member change form to the respective authority or department for processing and approval.
07
Follow up with the concerned department to ensure that the member change has been successfully processed.
Who needs member change form?
01
The member change form is typically needed by organizations or departments that maintain a record of their members or employees. It is used when there is a need to update or modify the existing member's information due to various reasons like resignation, transfer, promotion, or any other change in their status.
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