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Get Chapter 11 - Essential Cms-1500 Claim Instructions Flashcards ...

Al name including any suffix such as Sr., Jr., III, is required on this form. 2. ADDRESS. This information is required. If mailing address is different from residential address, complete mailing address section. 3. PERSONAL INFORMATION. A telephone number where you can be reached during normal business hours is helpful to registration officials if they have a question about your application. Social Security Number is required by O.C.G.A. 21-2-219 and 21-2-220. SSN is confidential by O.C.G.A.

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