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HEALTH INSURANCE BUY OUT PROGRAM ENROLLMENT FORM EMPLOYEE NAME ADDRESS SOCIAL SECURITY NUMBER FMH WORK LOCATION FMH START DATE HEALTH INSURANCE PLAN (at time of cancellation) INDIVIDUAL OR FAMILY

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What is rfmh start date?

RFMH start date refers to the date on which the Residential Facility for the Mentally Handicapped (RFMH) started its operations.

Who is required to file rfmh start date?

The owner or operator of the RFMH facility is required to file the RFMH start date.

How to fill out rfmh start date?

RFMH start date can be filled out by providing the specific date on which the facility started providing services to mentally handicapped individuals.

What is the purpose of rfmh start date?

The purpose of RFMH start date is to document when the facility began its operations for regulatory and compliance purposes.

What information must be reported on rfmh start date?

The information required to be reported on RFMH start date includes the specific date on which the facility commenced its operations.

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