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Name of Financial Aid Applicant (Please print): RETURN TO:Ant Financial Aid Office 8045 E. Chapman Ave., Rm. E104 Orange, CA 928694512 (714) 6284876FirstMiddle InitialStudent ID#: 20172018 INCOME

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How to fill out e-104

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To fill out an e-104 form, follow these steps:

02

Start by entering your personal information, such as your name, date of birth, and address.

03

Provide details about your healthcare coverage, including the country where you are insured and the name of your insurance provider.

04

Indicate the purpose for which you need the e-104 form.

05

Specify the period for which you require the form, stating the start and end dates.

06

Finally, sign and date the form to confirm its accuracy and completeness.

Who needs e-104?

01

E-104 forms are typically needed by individuals who are insured in one country but require healthcare services in another.

02

These forms are used to prove entitlement to healthcare benefits in the country where the insured person is seeking treatment.

03

For example, if you live in one EU member state but need medical treatment in another EU member state, you may need an e-104 form.

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What is e-104?

E-104 is a tax form used to report income earned by foreign individuals or entities in a particular country.

Who is required to file e-104?

Foreign individuals or entities earning income in a specific country are required to file e-104.

How to fill out e-104?

E-104 can be filled out by providing information about income earned, deductions, and any taxes paid in the specific country.

What is the purpose of e-104?

The purpose of e-104 is to report income earned by foreign individuals or entities and ensure compliance with tax laws in the specific country.

What information must be reported on e-104?

Information such as income earned, deductions, taxes paid, and any other relevant financial information must be reported on e-104.

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