Get Payment Reconciliation Summary Reports (prs) - Palmetto Gba

Understanding how to accurately complete the Payment Reconciliation Summary Reports (PRS) is essential for effective communication with Palmetto GBA. This guide provides a clear, step-by-step process to assist users in filling out the form correctly and efficiently.

Follow the steps to complete the Payment Reconciliation Summary Reports (PRS) online.

1. Press the ‘Get Form’ button to obtain the document and open it in your preferred editor.
2. In the 'Company Name' field, enter the name of your organization as registered.
3. Fill in your complete 'Address,' ensuring all details are accurate.
4. Provide the 'City, State, Zip' information related to your address.
5. In the 'Contact Person' field, enter the name of the individual who will serve as the point of contact.
6. Enter the 'E-Mail address' for correspondence regarding the PRS.
7. Provide a 'Phone Number' where the contact person can be reached.
8. List the contract number(s) that you are authorizing to receive the Payment Reconciliation Summary Reports.
9. If you require additional space for more contract numbers, make a copy of the page, list the numbers, and attach it to the form.
10. Indicate your 'Internet Connection Type' by selecting from the options provided: High Speed (cable, DSL, T-1, etc.), Dial Up/Modem, or Other (please specify).
11. Sign the document in the 'Signature' field, confirming your authorization to submit the document.
12. Print your name in the 'Printed Name' section.
13. Include your 'Title' in the appropriate box.
14. Date the document by entering today's date in the designated field.
15. Make a copy of the completed form for your records as advised.
16. Mail the form with the original signature to PDE PRS Reports, ensuring it is sent to the correct address.

Complete your Payment Reconciliation Summary Reports online to ensure a smooth submission process.