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58771REQUEST FOR ACCESS TO PROTECTED HEALTH INFORMATION NORTH DAKOTA PUBLIC EMPLOYEES RETIREMENT SYSTEM SON 58771 (Rev. 012017)PAPERS 400 East Broadway PO Box 1657 Bismarck North Dakota 585021657
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01
Start by entering the current date in the appropriate field.
02
Provide the name of the organization or company for which the notice is being filled out.
03
Fill in the existing member data that needs to be updated.
04
Clearly state what changes are being made to the member data.
05
Provide any necessary supporting documentation or evidence for the changes made.
06
Sign the notice and provide your contact information for any further communication.
07
Submit the filled out notice to the designated department or individual responsible for member data management.

Who needs notice of change-member data?

01
Notice of change-member data is generally needed by organizations or companies that maintain a membership database.
02
It is required when there are updates or modifications to be made regarding a member's data, such as the change of address, contact details, or any other relevant information.
03
These notices ensure that the organization has accurate and up-to-date information about its members.
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Notice of change-member data is a formal document that reports changes in the membership information of a business or organization, such as changes in ownership, address, or contact details.
Businesses and organizations with membership structures, such as corporations, LLCs, and partnerships, are required to file a notice of change-member data when there are changes in membership information.
To fill out a notice of change-member data, individuals or representatives must provide details of the changes, including the names of new or departing members, their roles, and any other relevant information required by the governing authority.
The purpose of the notice of change-member data is to ensure that public records are up-to-date and accurate regarding the members of a business or organization, facilitating transparency and compliance with legal requirements.
The information that must be reported includes the names of the members whose information is changing, their new or updated contact details, and any relevant role or ownership changes.
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