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Important Please submit this form to: 1201 Elm Street Dallas, Texas 75270 benefits.benefits@dallascounty.orgGROUP OPTIONAL LIFE INSURANCE APPLICATION Dallas County Group #681714 Evidence of Insurability
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Employee self refers to the process by which employees report their earnings, tax withholdings, and other information for the purpose of tax compliance and benefits eligibility.
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Information that must be reported includes total earnings, tax withholdings, deductions, and personal identifying details.
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