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| 2010 Scope of Appointment Form |
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Must be signed with every Part D or Medicare Advantage Application |
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Scope of Appointment (32 kb) |
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| 2010 Part D Evidence of Coverage |
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Booklet with details about the PDP plans. |
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S5743_092509_C01 RE (474 kb) |
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| 2010 Part D EFT Form |
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To be used after issue only, may not be submitted with a new application. |
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RAS1009R02 (9/09) (121 kb) |
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