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Declaration of Good HealthPolicy Number: Name of the life assured: Questions pertaining to the life AssuredYesNoDetails1. Are you at present in good health? 2. Are you physically handicapped or having
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The name of the form is Life Insurance Information Reporting.
Insurance companies or other entities that issue life insurance contracts are required to file the form.
The form can be filled out electronically or by mail, and must include information about the policyholder and the insurance contract.
The purpose of the form is to report information about life insurance contracts to the IRS for tax purposes.
Information such as the policyholder's name, address, taxpayer identification number, insurance contract number, and amount of death benefit must be reported.
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