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AUTHORIZATION FOR RELEASE OF PROTECTED HEALTH INFORMATION Patient Name: ___ Birth Date: ___ Maiden/Prior Names: ___ Current Phone #: ___ Current Address: ___ Last 4 of SS#: ___ To be released to or

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How to fill out current address last 4

01

Locate the section asking for your current address last 4 digits.

02

Look at your current address and identify the last 4 digits of your zip code.

03

Enter these last 4 digits into the designated area on the form.

Who needs current address last 4?

01

Organizations or institutions that require additional verification or security measures may ask for your current address last 4 digits.

02

It is commonly used by banks, credit card companies, or government agencies for identity verification purposes.

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What is current address last 4?

The current address last 4 refers to the last 4 digits of the current address where the individual resides.

Who is required to file current address last 4?

Individuals who have changed their address within the reporting period are required to file the current address last 4.

How to fill out current address last 4?

To fill out the current address last 4, individuals need to provide the last 4 digits of their current address where they currently reside.

What is the purpose of current address last 4?

The purpose of the current address last 4 is to ensure that the individual's current address is up to date for communication and verification purposes.

What information must be reported on current address last 4?

Only the last 4 digits of the current address where the individual resides must be reported on the current address last 4 form.

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