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RepresentativeInformation [CET]

Representative Information [CET]

Representative Information is as follows. The required information is bold.

  • Rep LastName
  • Rep FirstName
  • Rep MI
  • Rep Suffix
  • Rep SSN
  • Rep EstateTaxID
  • Complete Rep Address
  • Rep Relationship
    • valid relationship values (choose only one)
      • Guardian/Admin
      • Other
      • Relative

A Representative is only required if the Claimant is deceased.

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