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Provider Name Provider Address (physical & mailing) Provider Address (City, ST, & Zip)Affidavit of Lost/Missing Receipt The BET program requires participants to provide receipts for participant reimbursements
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On the next line, write the street address or P.O. Box number.
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A physical mailing address is the physical location where mail can be sent and received by an individual or organization.
Any individual or organization that needs to receive physical mail or packages is required to have a physical mailing address.
To fill out a physical mailing address, you will need to include the recipient's name, street address, city, state, and zip code.
The purpose of a physical mailing address is to provide a location for mail and packages to be delivered to an individual or organization.
The information that must be reported on a physical mailing address includes the recipient's name, street address, city, state, and zip code.
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