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3. Home AddressStreet6. City
11.
Male
Female2. Group Insurance Enrollment Card
Social Security Number4. Name of EmployerState10. Middle Initial Code
12. Date of Birth (M, D, Y)Single
Married7. Full
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What is ga124-hdoc?
Ga124-hdoc is a tax form used by individuals to report certain information regarding their health coverage.
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Individuals who have health coverage are required to file ga124-hdoc.
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Information such as the type of health coverage, the duration of coverage, and any dependents covered must be reported on ga124-hdoc.
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