LEGACY UB-92 (759) IB FORM SKELETON DEFINITION (364.6)
Name
Value
BILL FORM
LEGACY UB-92
SECURITY LEVEL
NATIONAL,NO EDIT
PAGE OR SEQUENCE
1
FIRST LINE NUMBER
64
LOCAL OVERRIDE ALLOWED
YES
STARTING COLUMN OR PIECE
1
LENGTH
48
SHORT DESCRIPTION
REMARKS LINE 4 (FL-84d)