GUM

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Out of Area treatment for GUM

1. Out of Area Provider
2. Business Name
3. Address
4. Town
5. Post Code
6. Telephone
7. Email Address
8. Contact Name
9. Title
10. Forename
11. Surame
12. Contact Telephone Number
13. Fax Number
14. VAT Registration Number

1. Bank Details for Payments
2. Bank Name
3. Bank Address
4. Bank Sort Code
5. Bank Account Name
6. Bank Account Number
7. Email Address for remittance advice
8. Approximate Amount Claimed

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