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MASSACHUSETTS STANDARD FORM FOR PRIOR AUTHORIZATION REQUESTS *Some plans might not accept this form for Medicare or Medicaid requests. A. Destination Health Plan or Prescription Plan Name: Health
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It is for reporting income and deductions for Massachusetts state taxes.
Residents and non-residents who earned income in Massachusetts are required to file.
You must gather all necessary income and deduction information and enter it in the form following the instructions provided.
The purpose is to calculate the correct amount of state taxes owed based on income and deductions.
Income such as wages, interest, dividends, and deductions such as student loan interest, retirement contributions.
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