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1. Name of Applicant :___ (Include all DBA\'s and subsidiaries seeking coverage under the policy for which you are applying.) Address:___Streetcar/StateZip2. Internet Address:___3. ___Corp ___Partnership
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www2immscommembers3rdpartyapplicant name refers to the name of the third-party applicant being reported in the system.
Any party involved in the application process who is designated as a third-party applicant is required to file their name in the system.
You can fill out the www2immscommembers3rdpartyapplicant name by logging into the system and entering the necessary information in the designated fields.
The purpose of reporting the www2immscommembers3rdpartyapplicant name is to accurately identify the third-party applicant involved in the application process.
The www2immscommembers3rdpartyapplicant name must include the full legal name of the third-party applicant.
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