Get Employer Or Self Insured Employer Request For Change Of Address H22r 9/2008. Form H22r Version

This guide provides clear and supportive instructions for completing the Employer Or Self Insured Employer Request For Change Of Address H22R 9/2008 form. It ensures that your address change is registered accurately with the Commission, facilitating a smooth transition in your mailing address.

Follow the steps to fill out the form correctly.

1. Click the ‘Get Form’ button to acquire the form and open it in your preferred document editing tool.
2. Fill in the Company Name and Federal Employer Identification Number (FEIN). Ensure this information matches your records to avoid processing delays.
3. Provide the new address in the designated fields: Street, Additional Info (such as apartment or suite number), City, State, and ZIP Code.
4. Next, fill in the prior address in the same format: Street, Additional Info, City, State, and ZIP Code. This is crucial for the Commission to locate your existing records.
5. Indicate the capacity in which the request is being made by selecting the appropriate option: Employer, Self-Insured Employer, or Employer/Self-Insured Employer Attorney.
6. Provide the Name and Title of the Authorized Individual completing the form. This ensures accountability and clarity regarding who is making the request.
7. Include the Telephone Number for contact purposes in case further information is required.
8. Sign and date the form in the indicated sections. The signature of the Authorized Individual is mandatory for processing.
9. After completing all fields, review the form for accuracy, then save your changes. You may download, print, or share the completed form according to your needs.

Complete your Employer Or Self Insured Employer Request For Change Of Address online today.