Common use of Additional Contacts Clause in Contracts

Additional Contacts. In addition to the Primary and Alternate Representatives, permission is granted to contact and share information with the following individuals should the need arise (optional): Please indicate level of access granted: Verbal Communication Online Account Access Request Benefit Recertification Documents Work Phone: ciary*: Name: Organization: Address: City, State, Zip: Home Phone: Cell Phone: Email: Relationship to Benefi Please indicate level of access granted: Verbal Communication Online Account Access Request Benefit Recertification Documents Work Phone: ciary*: Name: Organization: Address: City, State, Zip: Home Phone: Cell Phone: Email: Relationship to Benefi Please indicate level of access granted: Verbal Communication Online Account Access Request Benefit Recertification Documents Work Phone: ciary*: Name: Organization: Address: City, State, Zip: Home Phone: Cell Phone: Email: Relationship to Benefi Please indicate level of access granted: Verbal Communication Online Account Access Request Benefit Recertification Documents Work Phone: ciary*: Name: Organization: Address: City, State, Zip: Home Phone: Cell Phone: Email: Relationship to Benefi GRANTOR INITIALS

Additional Contacts. In addition to the Primary and Alternate Representatives, permission is granted to contact and share information with the following individuals should the need arise (optional): Name: Please indicate level of Organization: access granted: Verbal Communication Online Account Access Request Benefit Recertification Documents Work Phone: ciary*: Name: Organization: Address: City, State, Zip: Home Phone: Work Phone: Cell Phone: Email: Relationship to Benefi Please indicate level of access grantedBeneficiary*: Verbal Communication Online Account Access Request Benefit Recertification Documents Work Phone: ciary*: Name: Please indicate level of Organization: access granted: Address: City, State, Zip: Home Phone: Work Phone: Cell Phone: Email: Relationship to Benefi Please indicate level of access grantedBeneficiary*: Verbal Communication Online Account Access Request Benefit Recertification Documents Work Phone: ciary*: Name: Please indicate level of Organization: access granted: Address: City, State, Zip: Home Phone: Work Phone: Cell Phone: Email: Relationship to Benefi Please indicate level of access grantedBeneficiary*: Verbal Communication Online Account Access Request Benefit Recertification Documents Work Phone: ciary*: Name: Please indicate level of Organization: access granted: Address: City, State, Zip: Home Phone: Work Phone: Cell Phone: Email: Relationship to Benefi Beneficiary*: Verbal Communication Online Account Access Request Benefit Recertification Documents GRANTOR INITIALS