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REQUEST FOR MEDICARE PRESCRIPTION DRUG COVERAGE DETERMINATION This form may be sent to us by mail or fax: Address: Welfare Health Plans P. O. Box 31397 Tampa, FL 33631Fax Number: 18663881767You may
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866 388 1767 is a form used by taxpayers to report certain financial information to the IRS.
Taxpayers who meet specific criteria related to foreign investments or ownership are required to file this form.
To fill out the form, provide your personal information, details of your financial accounts or investments, and ensure all sections are completed accurately.
The purpose of the form is to ensure compliance with U.S. tax laws regarding foreign financial accounts and assets.
You must report personal identification details, account information, financial transactions, and foreign assets.
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