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Dependent Change Form
Use this form if you have family coverage and want to add or drop a spouse or dependent(s) but still keep coverage
for your other eligible family members. If you want to drop
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What is use this form if?
This form is used for reporting income tax information.
Who is required to file use this form if?
Individuals, businesses, and organizations that have taxable income.
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You can fill out the form online or by mail, providing accurate and complete information.
What is the purpose of use this form if?
The purpose of this form is to report taxable income to the tax authorities.
What information must be reported on use this form if?
Income, deductions, credits, and other relevant tax information.
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