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New Application Add a dependent. ID Number. (for additions). Dec 4 2014 03:19: 59 pm ...
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Provide your social security number and date of birth.
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It is a form used to report health insurance coverage.
Individuals who have health insurance coverage are required to file this form.
You can fill out the form electronically or manually with the required information about your health insurance coverage.
The purpose of this form is to provide information to the IRS about your health insurance coverage.
You must report details about your health insurance coverage, such as the type of coverage and the months you were covered.
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