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HEALTH BENEFITS PROGRAM APPLICATION SE HBP EDUCATION ACTIVE EMPLOYEE GROUPS Division of Pension and Benefits, P.O. Box 299,Trenton, NJ 08625-0299 HA-0890-1012 DIVISION USE ONLY 1. EMPLOYEE INFORMATION-This
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HA-0890 Active Ed Appqxp is a form used for reporting information related to educational activities.
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Educational institutions and organizations involved in educational activities are required to file HA-0890 Active Ed Appqxp.
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