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Only a medical provider local health department official school official or child care provider may sign Record of Immunization section of this form. This form may not be altered changed or modified in any way. This exemption does not apply during an emergency or epidemic of disease. DHMH Form 896 Rev. 2/14 Center for Immunization www. dhmh. maryland. gov How To Use This Form The medical provider that gave the vaccinations may record the dates us...
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What is 896 form?
The 896 form, also known as Form 896, is a tax form used for reporting information related to the health coverage provided by an employer to its employees.
Who is required to file 896 form?
Employers who offer health coverage to their employees are required to file Form 896 with the Internal Revenue Service (IRS).
How to fill out 896 form?
To fill out Form 896, employers need to provide information about the coverage offered, including the number of employees covered and the cost of coverage. They also need to provide the employer's identification number (EIN) and other relevant details.
What is the purpose of 896 form?
The purpose of Form 896 is to report health coverage information to the IRS and make sure that employers are complying with the requirements of the Affordable Care Act (ACA).
What information must be reported on 896 form?
Information that must be reported on Form 896 includes the employer's identification number (EIN), the total number of employees, the number of employees offered health coverage, the cost of coverage, and other details specified by the IRS.
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