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M3132 Rev. 3/9/20Place Patient Label Reinform PART A: PATIENT INFORMATION ACTION Patient Name: Address: Date of Birth:Phone:Email:SS# (last 4 digits):PART B: PERSON OR COMPANY WHO WILL RECEIVE INFORMATION
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To fill out Part B Person or, follow these steps:
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Start by providing personal information such as your name, address, and contact details.
03
Indicate your relationship to the person for whom the form is being filled out.
04
Provide information about the person, including their name, date of birth, and social security number.
05
Include any additional details that are required, such as the reason for filling out the form.
06
Double-check all the information provided to ensure accuracy.
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Sign and date the form at the designated area.
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Submit the completed form as instructed.

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Part B Person or is needed by individuals who are responsible for filling out specific forms or documents on behalf of someone else.
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This could include family members, legal guardians, or authorized representatives.
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The person for whom the form is being filled out may require assistance due to their age, physical condition, or language barrier.
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In some cases, professional service providers may also need to fill out Part B Person or to facilitate the completion of certain forms.
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Part B Person or refers to a specific section of a tax form used to report information about certain individuals involved in a business entity.
Individuals and entities that meet specific criteria related to ownership or control of the business must file Part B Person or.
To fill out Part B Person or, gather the required information about the individuals or entities, and follow the instructions on the form to report their details accurately.
The purpose of Part B Person or is to provide transparency regarding the individuals or entities that have a significant role or stake in the business operations.
The information that must be reported includes the names, addresses, and taxpayer identification numbers of the individuals or entities involved.
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