Fraud Acknowledgment Form
| P.O. Box 11579 | Rock Hill, SC 29731-1579 467 South Wilson Street Rock Hill, SC 29730 Telephone: 803.324.3060 | Fax: 803.324.5857 Monday - Friday: 8:00 AM - 5:00 PM www.rhha.org |
Fields marked with * must be filled out or form will not submit.