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Provider Inquiry Claim Form 470 3744

Provider Inquiry Claim Form 470 3744

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Instructions and help about medicaid iowa form 470 3744

laws.com legal forms guide proof of claim a proof of claim is submitted by creditors in a bankruptcy case to establish their claim for payment this is filled out in response to a notice that a bankruptcy case has been established by the Creditor in question the proof of claim form may be attached with this notice or obtained from the website of the United States court system step one enter the name of the dtor and the case number which has been assigned to their bankruptcy proceedings step two enter the name of the Creditor as well as the name address and contact information for where all subsequent notices regarding the progress of the case should be sent step three enter the address where payment should be sent if it is different from the address listed above step four enter the amount of the debt owed step five enter the nature of the debt incurred such as failure to pay for goods purchased or credit card debt step six enter the last four digits of the social security number or tax

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