Get the free Requestor Name and Address ORTHOTEXAS PHYSICIANS SURGEONS 4780 N JOSEY LANE CARROLLT...
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Texas Department of Insurance Division of Workers' Compensation Medical Fee Dispute Resolution, MS-48 7551 Metro Center Drive, Suite 100 Austin, Texas 78744-1645 512-804-4000 telephone 512-804-4811
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How to fill out requestor name and address:
01
Start by locating the designated spaces for requestor name and address on the form or document.
02
Provide your full legal name as the requestor. Include your first name, middle name (if applicable), and last name. Avoid using nicknames or aliases.
03
Next, enter your complete mailing address. This should include your street address, apartment or unit number (if applicable), city, state or province, postal code, and country. Make sure to be accurate and include any necessary details, such as the correct spelling of street names or apartment numbers.
Who needs requestor name and address:
01
Requestor name and address are typically required on various official forms and documents that involve personal identification or communication, such as job applications, legal documents, financial transactions, government forms, etc.
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These details are necessary for ensuring proper identification and contact information for the requestor. The recipient or organization processing the request may need to reach out to the requestor or send important documents, so accurate name and address information is crucial.
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What is requestor name and address?
The requestor name and address refer to the details of the individual or organization making a request. It includes their name, contact information, and physical address.
Who is required to file requestor name and address?
The party or entity making a request is required to file their name and address. It could be an individual, business, or any other organization.
How to fill out requestor name and address?
To fill out the requestor name and address, you need to provide the legal name of the requestor, their contact information (phone number, email address), and the physical address where they can be reached.
What is the purpose of requestor name and address?
The purpose of capturing the requestor's name and address is to ensure proper identification and contact information for communication and follow-up regarding the request.
What information must be reported on requestor name and address?
The information reported on the requestor name and address includes the requestor's full legal name, phone number, email address, and physical address.
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