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INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT We make Indiana a cleaner, healthier place to live. Frank Bannon Governor Lori F. Kaplan July 10, 2003, Commissioner TO: Interested Parties / Applicant
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Form Dallas Group is a form used for reporting group health coverage provided by an employer.
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Employers who provide group health coverage are required to file Form Dallas Group.
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Form Dallas Group can be filled out online or by mail using the instructions provided by the IRS.
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The purpose of Form Dallas Group is to report information about group health coverage provided by an employer.
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Information such as the employer's name, address, and identification number, as well as details about the group health coverage provided, must be reported on Form Dallas Group.
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