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UBO USE ONLY Retirement Date EE Med Part B 1st Payment Year PYC s TIAA-CREF MEDICARE-ELIGIBLE RETIREES APPLICATION FOR MEDICARE PART B PREMIUM REIMBURSEMENT No Changes To Current Information RETIREE INFORMATION Social Security Number -- Name Date of Birth Address No. and Street City State Zip Code College Retired From Marital Status Single Apt.
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No changes to current means that there have been no updates or modifications since the last report.
Any individual or entity who previously submitted a report and has had no changes to report.
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The purpose of no changes to current is to inform the relevant parties that there have been no updates or modifications to report.
The report must state that there have been no changes since the last report.
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