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Get and Sign C966 REV JAN 20192 Xdp 2019-2022 Form

Get and Sign C966 REV JAN 20192 Xdp 2019-2022 Form

Use a C966 REV JAN 20192 xdp template to make your document workflow more streamlined.

REPRESENTATIVE PO Box 2415 Edmonton AB T5J 2S5 Fax 780 427-5863 1-800-661-1993 Part 1 Instructions and Important Information Part 1 This form is to be used when an employer wishes to authorize a representative to have access to their account or claim information as defined by the levels of authorization see Part 2 section C. Electing to authorize a representative at this level will exclude any other selections as any other selection would create an overlap of authorization. - Ongoing claims...
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