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2018 Tobaccos Surcharge Affidavit If you are enrolling in a 2018 SCL Health medical plan and: If there is only one adult covered on the medical plan who currently uses or has used tobacco products
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How to fill out 2018 tobacco-use surcharge affidavit

01
Obtain the 2018 tobacco-use surcharge affidavit form from the appropriate source.
02
Read the instructions provided with the form to understand the requirements and process.
03
Gather all necessary information and documents needed to complete the form, such as personal details, tobacco-use information, and supporting evidence.
04
Carefully fill out the form, following the instructions and providing accurate and complete information.
05
Double-check the form for any errors or missing information.
06
Sign and date the affidavit as required.
07
Submit the completed form to the designated authority or organization, either in person or by mail.

Who needs 2018 tobacco-use surcharge affidavit?

01
Anyone who has used tobacco during the year 2018 and is required to report this information or pay a tobacco-use surcharge may need the 2018 tobacco-use surcharge affidavit. The specific individuals or organizations requiring this form may vary depending on local laws, regulations, insurance policies, or other applicable requirements.
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Tobacco-use surcharge affidavit is a document that individuals or organizations must complete to report their tobacco usage and pay any required surcharges.
Any individual or organization that uses tobacco products may be required to file a tobacco-use surcharge affidavit.
To fill out a tobacco-use surcharge affidavit, individuals or organizations must provide information about their tobacco usage and calculate any required surcharges.
The purpose of the tobacco-use surcharge affidavit is to ensure that individuals or organizations using tobacco products are paying the appropriate surcharges.
The tobacco-use surcharge affidavit must include information about the type and quantity of tobacco products used, as well as any related surcharges.
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