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Completing New Associated Party Entry (Licensed Program: Organization)


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:

Organization

Type of Business*

Select the type of business by using the down arrow () next to the field.

Corporation

Sole Proprietorship

Partnership

Organization or Last Name*

This name is carried forward from the search results page; however it may be changed if necessary.  If the provider is an organization, that name appears in the Last Name field.

Non Profit Business*

Select either Yes or No by using the radio button next to the field ().

EIN (Employer Identification Number)/SSN (Social Security Number)*

Enter the Employer Identification or Social Security Number for the owner.

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.

City

Type the name of the city in this field.

Town

Select the name of the town by using the down arrow () next to the 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 #####-####.


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Submitting Licensed Program Organization Party Information