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STATEMENT OF NO LOSS AGENCY NAMED INSURED Anderson GMI Insurance Agency, LLC 5965 S. Redwood Road, Suite 200 TAYLORSVILLE, UT 84123 CONTACT NAME: PHONE (A/C, No, Ext): FAX (A/C, No): EMAIL ADDRESS:

How to fill out 5965 s

How to fill out 5965 s:

1. Start by obtaining the 5965 s form from the appropriate government agency or website.
2. Carefully read the instructions provided with the form to ensure that you understand the requirements and necessary information.
3. Begin by entering your personal information, including your name, address, and social security number, in the designated fields.
4. Provide details regarding your employer, including their name, address, and contact information.
5. Fill in the sections that require information about your health insurance coverage, such as the type of coverage, effective dates, and any changes in coverage during the year.
6. If you are claiming an exemption or a waiver, make sure to provide the necessary documentation or explanation as instructed on the form.
7. Double-check all the information you provided and make sure it is accurate and complete.
8. Sign and date the form, certifying that the information you provided is true and accurate to the best of your knowledge.

Who needs 5965 s:

1. Individuals who have had health insurance coverage through the Health Insurance Marketplace.
2. Those who have received advanced premium tax credits to help pay for their health insurance premium.
3. Individuals who are claiming an exemption from the requirement of having health insurance coverage for a specific period.
4. Taxpayers who are requesting a waiver of the penalty for not having health insurance coverage.

Please note that this information is provided as a general guide and may vary depending on individual circumstances. It is always recommended to consult with a tax professional or refer to the specific instructions provided with the form for accurate and personalized guidance.

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What is 5965 s?

5965 s is a form used to report information regarding certain foreign financial assets.

Who is required to file 5965 s?

U.S. citizens, resident aliens, and certain non-resident aliens are required to file 5965 s if they have specified foreign financial assets.

How to fill out 5965 s?

5965 s can be filled out electronically or by paper, and it requires detailed information about the foreign financial assets.

What is the purpose of 5965 s?

The purpose of 5965 s is to report foreign financial assets that may be subject to reporting under the Foreign Account Tax Compliance Act (FATCA).

What information must be reported on 5965 s?

Information such as the type of foreign financial asset, the maximum value during the year, and detailed account information must be reported on 5965 s.