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Form LG02 Revised 10/20FOR LIB USE ONLYLOCAL GOVERNMENT HEALTH INSURANCE PROGRAM 2021 STATUS CHANGE Format: Initials:SUBSCRIBER INFORMATION (Please print or type.) Name (First, Middle Initial, Last)
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For lghib use only refers to a designation indicating that a specific document or information is restricted to internal use within an organization or for a particular purpose related to lghib.
Individuals or organizations that are involved in activities related to lghib and need to submit documentation for compliance or regulatory purposes are required to file for lghib use only.
Filling out for lghib use only involves providing accurate and relevant information pertaining to the organization's activities, ensuring all required fields are completed and any necessary documentation is attached.
The purpose of for lghib use only is to maintain confidentiality and restrict access to sensitive information that is pertinent to lghib, ensuring that only authorized personnel can view or use the data.
Information that must be reported includes organizational details, relevant activities, compliance data, and any other information pertinent to lghib's guidelines and requirements.
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