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Accounting/Billing Information

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Instructions for completing the Tax Information Page.

Select the Application Type from the left navigation menu.

Accounting/Billing Address: This location is for TMHP to know where to send your mail such as a 1099 Form, Claims Correspondence, and payment information.

Select +Add Accounting/Billing Information.

Complete the Accounting/Billing Address and Contact Information.

Note: if the address requires corrections or changes and is greyed out, select “Click to change address” checkbox to make edits.

Contact - First Name - Enter the Contact's First Name.

Contact - Middle Name (optional) - Enter the Contact's Middle Name if they have one.

Contact – Last Name - Enter the Contact's Last Name.

Street Address 1 - Enter the Contact's Street Address .

Street Address 2 - Enter the Suite Number or Apartment Number. (if applicable)

City - Enter the City.

State - Enter the State.

ZIP Code - Enter the State.

Zip+4 (optional) - Enter the Zip code +4.

Click “Verify Address”.

Note: if the address is not verified, you may select “Continue with Address entered.

Complete the following for the contact information for this registration application.

Contact Phone Number - Enter your telephone number.

Extension (optional) - This information is not required.

Contact Fax Number - This information is not required.

Attachments

If you have attachments to upload, select “Click here to select files” to upload your documentation.

Click Save.

Once complete, go to the left-hand section of the page and select the Form W-9 page.

Instructions for updating the Tax Information Page.

Accounting/Billing Information

Verify the information for the location already on file is accurate. If you require any edits, click the ellipses (…) and select Open to review the information on file.

Review/Update the Accounting/Billing Address and Contact Information.

Note: if the address requires corrections or changes and is greyed out, select “Click to change address” checkbox to make edits.

Contact - First Name - Review/Update the Contact's First Name.

Contact - Middle Name (optional) - Review/Update the Contact's Middle Name if they have one.

Contact – Last Name - Review/Update the Contact's Last Name.

Street Address 1 - Review/Update the Contact's Street Address .

Street Address 2 - Review/Update the Suite Number or Apartment Number (if applicable)

City - Review/Update the City.

State - Review/Update the State.

ZIP Code - Review/Update the State.

Zip+4 (optional) - Review/Update the Zip code +4.

Click “Verify Address”.

Note: if the address is not verified, you may select “Continue with Address entered.

Review/Update the following for the contact information for this registration application.

Contact Phone Number - Review/Update your telephone number.

Extension (optional) - This information is not required.

Contact Fax Number - This information is not required.

Attachments

If you have attachments to upload, select “Click here to select files” to upload your documentation.

Click Save.

Once complete, go to the left-hand section of the page and select the Form W-9 page.

This page is not applicable for Maintenance selection. Please continue to the next page.