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Get the free hr0944.pdf. State and Local Government Retirees Health Benefits Enrollment and Chang...

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HR09440220State Health Benefits Program (SHIP) State/Local Government RetireesRETIREE HEALTH BENEFIT ENROLLMENT AND/OR CHANGE FORM MEDICARE ENROLLEES1.MEMBER INFORMATION Last NameFirstMI GenderBirth
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HR0944PDF state and local refers to a specific form used by state and local entities to report certain financial and employment information.
Entities such as state and local governmental agencies or organizations that meet specific criteria related to employment and financial reporting are required to file the HR0944PDF.
To fill out the HR0944PDF, follow the instructions provided on the form, ensuring all necessary information about employment, finances, and relevant dates is accurately completed.
The purpose of the HR0944PDF is to ensure proper reporting of financial and employment data for compliance with state and local regulations.
The HR0944PDF requires reporting of information such as employee wages, taxes withheld, and any relevant financial data pertaining to the state or local entity.
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