LEGACY HCFA-1500 (538)    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 31
LOCAL OVERRIDE ALLOWED YES
STARTING COLUMN OR PIECE 57
LENGTH 22
SHORT DESCRIPTION INSUREDS SIGNATURE (BX-13)