Contents
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Completing New Associated Party Entry (Licensed Program: Individual)
Complete the details for the party on the Add Associated Party page (PM0120) as described below.
Owner Type
This value is carried forward from the Search function and contains one of the following:
Individual
Last*, First and Middle Names and Suffix
The name will be carried forward from the entry made on the search page or due to the selection of the Use Selected function. If the name is carried forward by using the function Create New Party, you may change the name of the provider in the appropriate name fields.
Date of Birth
Enter the date of birth using the following format MM/DD/YYYY.
Gender
Select Female or Male by using the radio button next to the field (
).
Home/Location Address
Enter the first line of the home/location address in this field.
Address Line 2
Enter the second line of the home/location address in this field.
Town
Select the name of the town by using the down arrow (
) next to the field.
City
Type the name of the city in this field.
State
The State has been defaulted to Vermont; however if another selection is needed, select the name of the state by using the down arrow () next to the field.
Zip Code
Enter the zip code in this field using the format #####-####.
Mailing Address
Enter the first line of the Mailing Address in this field.
Mailing Address Line 2
Enter the second line of the Mailing Address in this field.
Town
Select the name of the town by using the down arrow () next to the field.
City
Type the name of the city in this field.
State
The State has been defaulted to Vermont; however if another selection is needed, select the name of the state by using the down arrow () next to the field.
Zip Code
Enter the zip code in this field using the format #####-####.
More:
Employment/Position Information (LP)
Record Check Authorization (LP)
Submitting Licensed Program Individual Party Information