ir-representativeinformation
Representative Information
Representative Information
Representative Information is as follows. The required information for any representative information to be processed by the SimpleBatch system is in bold. If the minimum required information is not provided, no representative data will be imported into eClaims.
Rep LastName
Rep FirstName
Rep MI
Rep Suffix
Rep EstateTaxID
If available enter the Tax ID for the decedent’s estate. DO NOT enter the SSN, Int’l ID or Tax ID for the personal representative.
Complete Rep Address
Rep Relationship
valid relationship values (choose only one)
Guardian/Admin
Other
Relative
A Representative is only required if the Claimant is deceased.