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Underwritten by COSTCO WHOLESALE CORPORATION Unum Life Insurance Co of America LTC Department 2211 Congress Street Portland Maine 04122 Your Name Last Name First Middle Initial EMPLOYEE SPOUSE OR DOMESTIC PARTNER Group 5 Benefit Election Form Long Term Care Policy 543523-002 Social Security Number - - Gender Male Female Home Telephone Street Address City State Zip Code Complete the following only if applicant is not the employee Employee s Name Employee Social Security No. Date of Birth...
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How to fill out Costco Maine form:
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Gather all necessary information and documents required to complete the form, such as personal information, employment details, and any supporting documentation.
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Begin by entering your personal information accurately, including your full name, address, contact details, and social security number if applicable.
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Who needs the Costco Maine form:
01
Individuals who wish to become a member of Costco in Maine and avail its benefits and services.
02
Prospective employees of Costco in Maine who are required to fill out the form as part of the employment process.
03
Existing members of Costco in Maine who need to update their personal or financial information.
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What is costco maine form?
The costco maine form is a document required by the state of Maine for reporting the financial information of a Costco business operating in Maine.
Who is required to file costco maine form?
Any Costco business operating in Maine is required to file the costco maine form.
How to fill out costco maine form?
The costco maine form can be filled out by providing the required financial information of the Costco business in Maine as specified by the state of Maine.
What is the purpose of costco maine form?
The purpose of the costco maine form is to gather financial information from Costco businesses in Maine for tax and regulatory purposes.
What information must be reported on costco maine form?
The costco maine form requires the reporting of various financial details such as income, expenses, assets, and liabilities specific to the Costco business in Maine.
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