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VALLEYVIEWSCHOOL DISTRICT365U
801NormantownRd,RomeovilleIL604468158866386faxSPOUSE/CIVILUNIONPARTNERHEALTHPLANCOVERAGEAFFIDAVIT
Spouses/civilunionpartnersthatdonothaveeligibilityrightstoanyotheremployerhealthinsuranceplanare
eligibletoremainenrolledintheValleyViewHealthplan.
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How to fill out working spouse affidavit 2017
How to fill out working spouse affidavit 2017
01
To fill out the working spouse affidavit for 2017, follow these steps:
02
Obtain a copy of the working spouse affidavit form for 2017 from your employer or the appropriate government agency.
03
Start by providing your personal information, such as your name, address, and contact details.
04
Provide information about your spouse, including their name, employer information, and income details.
05
Indicate whether your spouse has access to certain benefits, such as health insurance coverage.
06
Sign and date the affidavit to certify the accuracy of the information provided.
07
Submit the completed working spouse affidavit to your employer or the relevant authority as instructed.
08
Note: The exact process and requirements for filling out the working spouse affidavit may vary depending on your employer or the specific government agency.
Who needs working spouse affidavit 2017?
01
The working spouse affidavit for 2017 is typically required by individuals who are employed and have a spouse who is also employed.
02
This affidavit is commonly used by employers to determine if an employee's spouse has access to certain benefits, such as health insurance coverage, provided by the employer.
03
It helps the employer assess the eligibility of the employee's spouse for these benefits and avoid potential duplication or misuse of benefits.
04
It is advisable to consult with your employer or refer to any specific guidelines or instructions provided to determine if you need to submit a working spouse affidavit for 2017.
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What is working spouse affidavit?
Working spouse affidavit is a legal document that declares the employment status and income of a spouse who contributes financially to the household.
Who is required to file working spouse affidavit?
Individuals who have a spouse that is employed and contributes to the household income are required to file the working spouse affidavit.
How to fill out working spouse affidavit?
To fill out the working spouse affidavit, individuals must provide details about their spouse's employment status, income, and any other relevant financial information.
What is the purpose of working spouse affidavit?
The purpose of the working spouse affidavit is to accurately report the combined income of a household, which may affect eligibility for certain benefits or tax credits.
What information must be reported on working spouse affidavit?
Information such as spouse's name, employer, income, and any other financial resources must be reported on the working spouse affidavit.
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