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2018 INDIVIDUAL/FAMILY PLAN NEW ENROLLMENT Application AND CHANGE IN COVERAGE Form help us process your Application promptly, please remember to: 1 Print all answers in blue or black ink only. Pencil

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Collect all relevant tax documents such as W-2 forms, 1099 forms, and receipts for deductible expenses.

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Sample - tax and is a financial document used to report income and expenses for tax purposes.

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