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To Employee: Complete Part 1 and arrange for your health care provider to complete Part 2. Return the completed form as soon as possible but no later than 15 calendar days after the date you receive
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Return the completed form is the finalized document that needs to be submitted to the appropriate authority.
Individuals or entities who are obligated by law to report certain information are required to file return the completed form.
Return the completed form can be filled out either manually or electronically, following the instructions provided by the issuing authority.
The purpose of return the completed form is to provide accurate and necessary information to the relevant authority for regulatory or compliance reasons.
Return the completed form usually requires information such as personal details, financial data, and any other relevant information specified by the issuing authority.
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