Get Xx Xx Rep

Filling out the Xx Xx Rep form online can be a straightforward process with the right guidance. This comprehensive guide will walk you through each section of the form, ensuring you understand what is required and how to complete it efficiently.

Follow the steps to successfully complete the Xx Xx Rep form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Complete the ‘Required Information’ section. Here, you need to enter the employer or participant's name along with the CDC+ ID number. Make sure to print this information clearly.
3. Fill out the Direct Deposit section to specify where you want your payments deposited. Indicate your preferred bank account type (checking or savings), enter the bank name, bank routing number, and bank account number.
4. Attach a voided check with your name printed on it, or provide a bank letter if a voided check is unavailable. This attachment is essential for processing your request.
5. Sign at the bottom of the form to authorize the direct deposit request.
6. Retain a copy of this form for your records.
7. If the form is for a participant or their representative, submit it with the initial enrollment forms. If submitted later, mail it directly to the Consumer Directed Care Plus office at the provided address.
8. If applicable for a provider, submit this form with the initial provider packet accompanying the purchasing plan. If sent later, ensure it is mailed directly to the specified address.

Start filling out your documents online today!