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OMB No. No. 09381378 09381378 OMB Expires: 07/31/2023 Expires: 07/31/2023INDIVIDUAL ENROLLMENT REQUEST FORM TO ENROLL IN A MEDICARE ADVANTAGE PLAN (PART C) Who can use this form? People with Medicare
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What is exhibit 1 model individual?
Exhibit 1 model individual is a document that provides detailed information about an individual's personal and financial background.
Who is required to file exhibit 1 model individual?
Individuals who meet specific criteria set by the regulatory authority are required to file exhibit 1 model individual.
How to fill out exhibit 1 model individual?
Exhibit 1 model individual can be filled out by providing accurate and complete information as per the guidelines provided by the regulatory authority.
What is the purpose of exhibit 1 model individual?
The purpose of exhibit 1 model individual is to ensure transparency and compliance with regulations by disclosing relevant information about an individual.
What information must be reported on exhibit 1 model individual?
Exhibit 1 model individual must include information such as personal details, financial assets, liabilities, income sources, and any other relevant information required by the regulatory authority.
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