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Government forms
Form DMA-2191 - Mar 2018

Government forms

Form DMA-2191 - Mar 2018

Designation of Control Officer for FRR/BEER Reports

Form DMA-2191 is used to designate a Control Officer for Free Retailer's Report (FRR) Beer by the North Carolina Medicaid.

Originally published by: ncdhhs.gov

Used 34 times

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Frequently asked questions

Form DMA-2191 is used to designate a Control Officer for Free Retailer's Report (FRR) Beer by the North Carolina Medicaid. It is required to be filled by individuals or entities who are required to report FRR Beer to NC Medicaid. The document is submitted to North Carolina Medicaid.
Individuals or entities who are required to report FRR Beer to NC Medicaid.
The completed Form DMA-2191 should be submitted to the North Carolina Medicaid.

Used 34 times