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WORTHINGTON CITY SCHOOLS HEALTHCARE SAVINGS ACCOUNT 2016 ALL STAFF (INFORMATION ONLY, YOU WILL CHOOSE YOUR PAYROLL DEDUCTION WITH THE AMERICAN FIDELITY REPRESENTATIVE) Employee Name Employee ID (Please
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Important information that needs verification.
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Individuals or entities specified by regulations.
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Follow the guidelines provided by the relevant authority.
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To ensure accuracy and compliance.
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Specific details as outlined in the regulations.
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