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Change of Scheme Administrator / Practitioner Details
Select Scheme Administrator / Practitioner
details to be changed
Administrator
Practitioner
Administrator ID
Practitioner ID
Select Individual / Organisation
Individual
Organisation
Enter Old Details
Enter New Details
Title
Dr
Mr
Mrs
Miss
Ms
Title
Dr
Mr
Mrs
Miss
Ms
Surname
Surname
Forename
Forename
Second Forename
Second Forename
Address
Address
Postcode
Postcode
Country
India
Country
India
Telephone
Telephone
E-Mail
E-Mail
Organisation Name
Organisation Name
Address
Address
Postcode
Postcode
Country
India
Country
India
Telephone
Telephone
E-Mail
E-Mail
Mode of Communication
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Do you want all your Relief at Source records updated with these new details?
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