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Claim Action Request Forms form is available in electronic format for typing your information. Go to anthem.com Providers Nevada Answers Anthem Download Forms Claim Action Request Format (mm/dd/YYY):
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This form is available for individuals to report their annual income.
Individuals who earn income during the tax year are required to file this form.
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The purpose of this form is to report your income to the tax authorities.
You must report all sources of income, including wages, interest, and dividends.
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