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2011-2012 BENEFIT ENROLLMENT/CHANGE FORM Please complete this form in its entirety. 1. EMPLOYEE INFORMATION (Please Print CLEARLY) Last Name First Name Middle Initial ? Male ? Female Home Address
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How to fill out page 1 2011-2012 benefit?

01
Provide your personal information, such as name, address, and social security number.
02
Indicate your marital status and the number of dependents you have.
03
Enter your income details, including wages, salaries, and tips.
04
Specify any other sources of income you may have, such as rental income or self-employment earnings.
05
Report any deductions or adjustments to your income, such as student loan interest or contributions to retirement plans.
06
Calculate your total income by subtracting any deductions from your gross income.
07
Determine your tax liability based on the tax brackets and rates for the given tax year.
08
Claim any tax credits you are eligible for, such as the child tax credit or education credits.
09
Calculate your total tax liability after accounting for any credits.
10
Complete the signature section and submit the form to the appropriate tax authority.

Who needs page 1 2011-2012 benefit?

01
Individuals who earned income during the 2011-2012 tax year.
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Those who want to claim deductions, adjustments, or credits on their tax return.
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Taxpayers who need to report their income and calculate their tax liability for the given tax year.
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Page 1 benefit enrollmentchange is a form used to make changes to an employee's benefits during the annual enrollment period.
All employees who wish to make changes to their benefits must file page 1 benefit enrollmentchange.
To fill out page 1 benefit enrollmentchange, employees must provide their personal information, select the benefits they wish to change, and sign the form.
The purpose of page 1 benefit enrollmentchange is to allow employees to make changes to their benefits and update their coverage as needed.
Employees must report their personal information, current benefit selections, and any changes they wish to make to their benefits.
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