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THIS FORM MUST BE COMPLETED ANNUALLY Vermont Department of Labor DECLARATION OF HEALTH CARE COVERAGE EMPLOYER: This form is ONLY to be completed by employees if you offer and pay a portion of a health
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Who Needs This Form:
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Individuals applying for a specific license or permit may need to fill out this form. For example, someone seeking a driving license or a business permit may be required to complete this form.
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What is this form must be?
This form is a tax form.
Who is required to file this form must be?
Individuals or entities with taxable income.
How to fill out this form must be?
You can fill out this form online or by mail.
What is the purpose of this form must be?
The purpose of this form is to report income to the tax authorities.
What information must be reported on this form must be?
You must report your total income, deductions, and credits.
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