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FORM C
Pharmacy Services DSS Open Enrollment No. HHS0014137
Contact Person Information Form
Legal Name of Respondent:
This form provides information about the appropriate contacts in the respondents'
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How to fill out contact person information form
How to fill out contact person information form
01
Start by entering your full name in the designated field.
02
Provide your phone number including area code.
03
Enter your email address accurately for communication purposes.
04
Include your job title or position within the organization.
05
If required, enter the company name you represent.
Who needs contact person information form?
01
Businesses and organizations that require a point of contact for communication purposes.
02
Event organizers gathering contact information for attendees.
03
Educational institutions collecting information of emergency contacts for students.
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What is contact person information form?
The contact person information form is a document that collects details about an individual's or organization's designated contact person, who will be the point of communication for official matters.
Who is required to file contact person information form?
Typically, businesses and organizations that are registered with a regulatory authority or are required to maintain a registered agent must file the contact person information form.
How to fill out contact person information form?
To fill out the contact person information form, provide the required details such as the contact person's name, address, phone number, email, and any other specified information as directed on the form.
What is the purpose of contact person information form?
The purpose of the contact person information form is to ensure that regulatory authorities or relevant organizations have up-to-date contact information for designated representatives for communication purposes.
What information must be reported on contact person information form?
The information that must be reported typically includes the name, address, phone number, and email address of the contact person, along with any additional details required by the jurisdiction.
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