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Office of Student Health Benefits 2012-2013 Declaration of Domestic Partnership To enroll a domestic partner as a dependent on a University-sponsored Office of Student Health Benefits administered health plan complete this form and submit to the Office of Student Health Benefits. Please keep a copy of this form for your records. A. Primary Member Information Name last first middle initial Please print Date of birth mm/dd/yyyy Gender U of M ID number Social Security number Street address city...
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The declaration of form is a legal document that is used to report information regarding a specific subject.
The filing of the declaration form is typically required by individuals or entities who are mandated by law to provide certain information to the relevant authority.
To fill out the form of declaration, you will need to gather all necessary information and complete the required fields as per the instructions provided with the form.
The primary purpose of the form of declaration is to gather and report accurate information about a specific subject, ensuring compliance with relevant laws and regulations.
The specific information that must be reported on the form of declaration will vary depending on the nature of the subject being reported. It can include personal details, financial information, or any other relevant data as required by the authorities.
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