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Kaiser Foundation Health Plan of Washington
Medicare Advantage (HMO) election from
This application is for plans offered in the following counties: Island, San Juan, Skagit, and What com. Please print
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What is this application is for?
This application is for identifying tax exemptions.
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Individuals or organizations eligible for tax exemptions are required to file this application.
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The application can be filled out online or submitted in person at the tax office.
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The purpose of this application is to verify eligibility for tax exemptions.
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Applicants must report their personal or organizational financial information and reasons for requesting tax exemptions.
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