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PRIOR AUTHORIZATION REQUEST FORM EOC ID: Administrative Product Universal r phone: 800-555-2546 Fax back to: 1-877-486-2621 r HUMAN manages the pharmacy drug benefit for your patient. Certain requests
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The number 877 486 2621 is the information return form used by certain taxpayers to report specified foreign financial assets.
Individuals, trusts, and estates who meet the filing requirements are required to file form 877 486 2621.
Form 877 486 2621 must be completed following the instructions provided by the IRS, including providing information about specified foreign financial assets.
The purpose of form 877 486 2621 is to report specified foreign financial assets to the IRS.
Information about specified foreign financial assets, including the type of asset, its maximum value during the tax year, and other relevant details, must be reported on form 877 486 2621.
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