Prince Edward Island Canada Workers Compensation Appeal Tribunal
Appointed Representative Form. You can use our electronic version of the form by asking your. Web appointment of representative name of party medicare number (beneficiary as party) or national provider identifier (provider or supplier as party) section 1:
Prince Edward Island Canada Workers Compensation Appeal Tribunal
Web appointment of representative name of party medicare number (beneficiary as party) or national provider identifier (provider or supplier as party) section 1: If you are using this form to appoint a representative, you must complete sections 1, 2, and 3. You can use our electronic version of the form by asking your. Your representative must complete sections 5 and 7 of this form. Web contact your local hearing office and request an invitation to enroll. Appointment of representative to be completed by the. Web form approved omb no.
You can use our electronic version of the form by asking your. Your representative must complete sections 5 and 7 of this form. Web contact your local hearing office and request an invitation to enroll. If you are using this form to appoint a representative, you must complete sections 1, 2, and 3. Appointment of representative to be completed by the. Web appointment of representative name of party medicare number (beneficiary as party) or national provider identifier (provider or supplier as party) section 1: Web form approved omb no. You can use our electronic version of the form by asking your.
