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MICROPURCHASE NATIONAL DEFENSE AUTHORIZATION ACT (NCAA) SECTION 889 REPRESENTATION FORM Merchant/Company Name (Offer or)DUNS Number Cage Code NumberVersare Solutions LLC Owner or Authorized RepresentativeTitleSam
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How to fill out 889 form
01
Obtain the Form I-485 Adjustment of Status application.
02
Fill out Section A, which includes your personal information such as name, address, and contact information.
03
Complete Section B, which pertains to your immigration history and status.
04
Provide the necessary information in Section C regarding your employment history and current job.
05
Fill out Section D if applicable, which covers information about your spouse and children.
06
Review the completed form for accuracy and sign and date where indicated.
07
Submit the completed Form I-485 along with any supporting documentation to the appropriate USCIS office.
Who needs 889 form?
01
Individuals who are applying for adjustment of status in the United States.
02
Those who are looking to obtain a Green Card through marriage to a US citizen or permanent resident.
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What is 889 form?
The 889 form is a document used to report information on individuals and entities that are excluded from participating in federal healthcare programs.
Who is required to file 889 form?
Entities that receive federal funds through Medicare, Medicaid, or other healthcare programs are required to file the 889 form.
How to fill out 889 form?
The 889 form can be filled out electronically or by mail, providing information on excluded individuals or entities and the reason for exclusion.
What is the purpose of 889 form?
The purpose of the 889 form is to ensure compliance with federal regulations and prevent individuals or entities that are excluded from participating in federal healthcare programs from receiving payments.
What information must be reported on 889 form?
The 889 form requires reporting of information on excluded individuals or entities, including their name, address, and reason for exclusion.
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