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Get the free name, address, phone number change request - MN.gov

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IA Employee Enrollment / Change Application P. O Box 297 Minneapolis, MN 554250297Group Number Effective Data: 9528835950New Applicant Change of Coverage (explain change) Name/Address Change (note
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Start by writing your full name in the designated field.
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Name address phone number refers to the essential contact information of an individual or entity, typically required for formal documentation or filing purposes.
Individuals or businesses that are submitting official documents or forms that require identification and contact information are required to file their name, address, and phone number.
To fill out name address phone number, simply enter your full name, physical address including city and zip code, and your primary phone number in the designated fields on the form.
The purpose of collecting name address phone number is to establish the identity of the filer and provide a means of contact for official communication.
The information that must be reported includes the filer's full name, complete address, and a working telephone number.
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