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05/09/2017COPY FOR PUBLIC INSPECTION05/09/2017Form8868Application for Extension of Time To File an Exempt Organization Return(Rev. January 2014) Department of the Treasury Internal Revenue Service WII
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e5490ic5 peninsula regional medical is needed by individuals who are seeking medical services at Peninsula Regional Medical Center. This form helps the medical center collect essential information about the patient, their medical history, and insurance coverage to provide appropriate care and process billing.
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The e5490ic5 peninsula regional medical is a form used for reporting medical expenses and services provided by Peninsula Regional Medical Center.
Individuals who have received medical services from Peninsula Regional Medical Center are required to file the e5490ic5 form.
To fill out the e5490ic5 form, you will need to provide information about the medical services received, the dates of service, and the total expenses incurred.
The purpose of the e5490ic5 form is to report medical expenses accurately and efficiently for billing and insurance purposes.
The e5490ic5 form must include details such as patient information, service provider details, dates of service, and total expenses incurred.
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