Fillable form 13441 a

(April 2011) Instructions for Form 13441-A General Instructions Department of the Treasury Internal Revenue Service Health Coverage Tax Credit (HCTC) Monthly Registration Please follow the instructions below to complete Form 13441-A. Write your Social Security Number at the top of each document you are sending to the HCTC Program. Print or type your responses. To register for the monthly HCTC, you must complete...
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form 13441 a