LEGACY HCFA-1500 (529)    IB FORM SKELETON DEFINITION (364.6)

Name Value
BILL FORM LEGACY HCFA-1500
SECURITY LEVEL NATIONAL,NO EDIT
PAGE OR SEQUENCE 1
FIRST LINE NUMBER 23
LOCAL OVERRIDE ALLOWED YES
STARTING COLUMN OR PIECE 50
LENGTH 28
SHORT DESCRIPTION INSURED EMPLOYR NAME (BX-11B)