Get Pa Third Party Agency (tra) Registration Application - City Of Pittsburgh 2020-2025

Filling out the PA Third Party Agency Registration Application is a crucial step for agencies seeking recognition by the City of Pittsburgh. This guide provides a clear, step-by-step process to complete the application online, ensuring that you meet all requirements.

Follow the steps to successfully complete your application.

1. Click ‘Get Form’ button to obtain the application and open it in your editor.
2. Enter the Third Party Agency Name in the designated field. This identifies your agency on the application.
3. Input your L&I UCC Agency number and expiration date in the respective fields. This information helps to validate your agency's credentials.
4. Complete the mailing address section, including the city, state, and zip code. Accurate details allow for proper communication and document delivery.
5. Provide your contact information, including phone number, fax number, position, and email address. This ensures that the City can reach you regarding your application.
6. Insert your insurance information. Attach a certificate of insurance that documents your professional errors and omissions liability insurance, ensuring it meets the minimum coverage requirements.
7. Certify the accuracy of the provided information in the statement of truth section. This ensures compliance with city procedures and confirms your understanding.
8. Sign and date the application where indicated. Ensure your signature matches your printed name for verification.
9. Include any additional required documents, such as photocopies of ID, certification cards, evidence of experience, and criminal record checks for each individual performing TPA services.
10. Review the entire application for completeness and accuracy before submission. Once finalized, save your changes, download, print, or share the completed application as needed.

Complete your PA Third Party Agency Registration Application online today for prompt processing.