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Form Approved OMB No. 0938-1190 Application for Exemption from the Shared Responsibility Payment for Individuals who are Unable to Afford Coverage and are in a State with a Federally Facilitated Marketplace

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What is exemption application for insurance?

Exemption application for insurance is a document that allows individuals or organizations to apply for an exemption from purchasing certain types of insurance coverage.

Who is required to file exemption application for insurance?

Individuals or organizations who meet certain criteria set by insurance regulations are required to file exemption application for insurance.

How to fill out exemption application for insurance?

Exemption application for insurance can be filled out by providing necessary personal or organizational information, along with details of why exemption is being requested.

What is the purpose of exemption application for insurance?

The purpose of exemption application for insurance is to provide a formal request for exemption from purchasing specific insurance coverage.

What information must be reported on exemption application for insurance?

Information such as personal or organizational details, reason for exemption request, and any relevant supporting documents must be reported on exemption application for insurance.

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