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New Health Insurance Marketplace Coverage Options and Your Health CoverageForm Approved OMB No. 12100149 (expires 6302023)PART A: General Information When key parts of the health care law take effect
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This information is a report on financial expenses.
Any individual or business that incurred financial expenses.
The information can be filled out online or on paper forms provided by the tax authority.
The purpose is to track and report financial expenses for tax purposes.
All financial expenses incurred during the tax year.
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