Tennessee § 45-7-122 Authorized delegate reporting

Tennessee Statutes

§ 45-7-122 — Authorized delegate reporting

(a)Each licensee shall submit a report of authorized delegates within forty-five (45) days after the end of the calendar quarter.

(b)The authorized delegate report must include, at a minimum, each authorized delegate's:

(1)Company legal name;

(2)Taxpayer employer identification number;

(3)Principal provider identifier;

(4)Physical address;

(5)Mailing address;

(6)Business conducted in other states;

(7)Any fictitious or trade name;

(8)Contact person name, phone number, and email;

(9)Start date as licensee's authorized delegate;

(10)End date acting as licensee's authorized delegate, if applicable; and (11) Any other information the commissioner reasonably requires with respect to the authorized delegate.

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(a) Each licensee shall submit a report of authorized delegates within forty-five (45) days after the end of the calendar quarter. (b) The authorized delegate report must include, at a minimum, each authorized delegate's: (1) Company legal name; (2) Taxpayer employer identification number; (3) Principal provider identifier; (4) Physical address; (5) Mailing address; (6) Business conducted in other states; (7) Any fictitious or trade name; (8) Contact person name, phone number, and email; (9) Start date as licensee's authorized delegate; (10) End date acting as licensee's authorized delegate, if applicable; and (11) Any other information the commissioner reasonably requires with respect to the authorized delegate.

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