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For Employer Use: PAYROLL DEDUCTIONS MEDICAL DENTAL $ VISION $ DISABILITY $ $ Former Employer (if covered under MPSI) ADDITIONAL LIFE $ Basic Life Eff. Date (mm/dd/YYY) Other Coverage Eff. Date (mm/dd/YYY)
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Basic life eff refers to the basic life expenses that are essential for survival, such as food, shelter, and clothing.
All individuals who are seeking financial assistance or support are required to file basic life eff.
Basic life eff can be filled out by providing information about monthly expenses for basic needs such as housing, groceries, utilities, and transportation.
The purpose of basic life eff is to assess an individual's financial situation and determine the level of assistance or support they may need.
Information such as income, expenses for food, housing, utilities, transportation, and medical expenses must be reported on basic life eff.
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