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PEP FLEX/HRA Replacement/Additional Card Order Form560 East 200 South, Salt Lake City, UT 84102 8013667503 / 8007537703 Faxes: 8013667772 / Toll free FAX: 8007598772SECTION 1 EMPLOYEE INFORMATION
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To fill out the replacementadditional, follow these steps:
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Begin by entering the required personal information, such as your full name, address, and contact details.
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Who needs replacementadditional?

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Replacementadditional may be needed by anyone who has received a defective or damaged item, or those who wish to exchange a product for a different size, color, or variant. It is also used by individuals who need to request a replacement for items covered under warranty or return policies.
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Replacementadditional is a form used to report additional tax liability or adjustments related to previous filings.
Taxpayers who have additional tax obligations arising from previous tax returns must file replacementadditional.
To fill out replacementadditional, provide accurate details about your additional tax liability, reference previous filings, and complete all required sections according to the form instructions.
The purpose of replacementadditional is to ensure accurate reporting of tax obligations and to rectify discrepancies in previous tax filings.
Information such as taxpayer identification, year of previous filings, amounts of additional tax due, and any relevant adjustments must be reported on replacementadditional.
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