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Domestic Partner Affidavit Subscribers name Subscribers Anthem plan identification number Group name Group number Date As a condition of membership for Domestic Partners and their eligible children,
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6133nh b 109 dp is a tax form used to report income from gambling winnings.
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Individuals who have received gambling winnings of $600 or more in a calendar year are required to file 6133nh b 109 dp.
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You must report the amount of gambling winnings you have received and any taxes that have been withheld.
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