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Agency of Human Services Department for Children and Families Economic Services Division 1 South, 280 State Drive Waterbury, VT 056711020×phone×8022410592[fax×8022410460http://www.dcf.state.vt.usSEALED
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Start by downloading the HC 1 South 280 form from the official website.
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Read the instructions carefully to understand the information requested and any supporting documents required.
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Fill in your personal information accurately, including your full name, date of birth, and address.
04
Provide details about your current healthcare plan, including the plan name and identification number.
05
Indicate whether you are applying for a new health card or requesting a replacement.
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If you are applying for a new health card, provide the reason for the application (e.g., turning 18, becoming a permanent resident).
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Sign and date the form to certify the information provided.
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Attach any supporting documents requested, such as proof of residency or immigration status.
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Double-check all the information and documents before submitting the form.
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Submit the completed HC 1 South 280 form to the appropriate healthcare authority.

Who needs hc 1 south 280?

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Anyone who wants to apply for or replace a South 280 health card
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Individuals who are turning 18 years old and need to transition from a child health card
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Permanent residents who need to apply for a health card
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hc 1 south 280 is a tax form used for reporting income earned from self-employment.
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