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COBRA Continuation Coverage Election Notice
(For use by single employer group health plans)
Date:
(Enter date of notice)
To:
(Enter the names of the employee and/or dependents entitled to continuation)
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What is for use by single?
For use by single is a form that individuals who are unmarried and do not have any dependents can use to file their taxes.
Who is required to file for use by single?
Individuals who are unmarried and do not have any dependents are required to file for use by single.
How to fill out for use by single?
To fill out for use by single, individuals need to provide their personal information, income, deductions, and credit information.
What is the purpose of for use by single?
The purpose of for use by single is to report income, deductions, and credits for individuals who are unmarried and do not have any dependents.
What information must be reported on for use by single?
On for use by single, individuals must report their income, deductions, and credits.
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