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Return this form to END:Affidavit of Spousal Health Care Coverage This Affidavit must be completed for consideration to cover a spouse. Employee Name: Spouse Name:Employee SSN: Spouse SSN:To be completed
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The return should be filed with the appropriate government agency or tax authority.
Who is required to file return this form to?
Individuals or entities who meet the filing requirements set by the government agency or tax authority.
How to fill out return this form to?
The form should be completed with accurate and relevant information as requested by the government agency or tax authority.
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The purpose is to report income, expenses, and other financial information to the government agency or tax authority.
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Income, expenses, deductions, credits, and other financial information as required by the government agency or tax authority.
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