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WPADMPP006M Rev. 02/16 -OH 1010130 45693OHSENABS Med Supp Prem Pymnt Form - OH 04 14 Page 1 45693OHSENABS Rev. 02/16 BANK INFORMATION For Existing Member and New Applicant Deduct Premium Monthly Quarterly Annually Applicable discounts for monthly or annual Automatic Bank Draft are not guaranteed and are subject to change. I also understand that if corrections in the debit amount are necessary it may involve an adjustment credit or debit to my account. NEW APPLICANT Initial Submission of a...
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What is box 659816?
Box 659816 is a form used for reporting specific financial transactions to the IRS.
Who is required to file box 659816?
Individuals or businesses who engage in the types of transactions required to be reported on box 659816 are required to file it.
How to fill out box 659816?
Box 659816 should be filled out accurately and completely, following the instructions provided by the IRS.
What is the purpose of box 659816?
The purpose of box 659816 is to report certain financial transactions to the IRS for tax compliance purposes.
What information must be reported on box 659816?
Specific details about the financial transactions, such as amounts, dates, and parties involved, must be reported on box 659816.
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