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O. Box 91278 Baton Rouge LA 70821-9278 Monthly Income Limits Effective 03/01/17 QMB SLMB QI Individual Couple PHONE QMB pays your Medicare part B premium deductibles and coinsurance. Jr. II UNIT/APT STATE Party Affiliation DEM GRN IND LBT 8. REP NO PARTY OTHER Specify XXX XX Place of Birth 6. LDH cannot treat you differently because of race color sex age disability religion nationality or political belief. If you think it has you can call the U.S. DHHS Regional Office for Civil Rights...
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What is application office?
Application office is a form or document used to request or apply for a certain benefit or service.
Who is required to file application office?
Any individual or organization that wants to request a benefit or service may be required to file an application office.
How to fill out application office?
To fill out an application office, one must provide accurate and complete information as requested in the form.
What is the purpose of application office?
The purpose of application office is to formally request a benefit or service from a specific organization or entity.
What information must be reported on application office?
The information required on an application office may vary depending on the type of benefit or service being requested, but typically includes personal details, contact information, and specific requests.
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