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This version of the form is not currently in use and is provided for reference only. Download this version of
Form LTC-19
for the current year.
Form LTC-19 Request for Billing Assistance - New Jersey
What Is Form LTC-19?
This is a legal form that was released by the New Jersey Department of Human Services - a government authority operating within New Jersey. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form LTC-19?
A: Form LTC-19 is the Request for Billing Assistance form.
Q: What is the purpose of Form LTC-19?
A: The purpose of Form LTC-19 is to request billing assistance in relation to long-term care services in New Jersey.
Q: Who can use Form LTC-19?
A: Form LTC-19 can be used by individuals who require assistance with billing for long-term care services in New Jersey.
Q: Are there any fees associated with submitting Form LTC-19?
A: No, there are no fees associated with submitting Form LTC-19.
Form Details:
- Released on February 1, 2015;
- The latest edition provided by the New Jersey Department of Human Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form LTC-19 by clicking the link below or browse more documents and templates provided by the New Jersey Department of Human Services.
