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PAGE1Commonwealth of PennsylvaniaCampaign Finance Report (NOTE: This report must be clear and legible. It may be typed or printed in blue or black ink.) Filer Identification Number :1094 FIDDLEBACK
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Start by entering your personal information such as name, address, and social security number at the top of the form.
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Individuals who have received health coverage from their employer and need to report this to the IRS.
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1094 Fiddleback Dr is a fictional address used as an example in this context.
Employers or entities who are mandated by the IRS to report certain information related to health coverage must file Form 1094-Fiddleback Dr.
Form 1094-Fiddleback Dr should be completed with accurate information about the employer or entity providing health coverage.
The purpose of Form 1094-Fiddleback Dr is to provide the IRS with information about health coverage offered by the employer or entity.
Employers or entities are required to report information such as the number of full-time employees, the type of coverage offered, and other related details on Form 1094-Fiddleback Dr.
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