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EXCEPTION FORM FOR OPEN ENROLLMENT ONLY Fax to: 5025645278 MUST BE RECEIVED IN DEI BY 12/31/2020 Agency/Employer Name Agency Insurance Coordinator/HR Contact Today's Date: LANDHOLDERS PERSONAL INFORMATION
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How to fill out exception form

01
Obtain the exception form from the appropriate department or website.
02
Fill out your personal information such as name, address, phone number, and email.
03
Clearly state the reason for requesting an exception.
04
Provide any supporting documentation or evidence to strengthen your request.
05
Submit the completed form to the designated individual or department for review.

Who needs exception form?

01
Anyone who needs to request an exception to a rule, policy, or procedure.
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Exception form is a form used to report any discrepancies or deviations from standard procedures.
Any individual or organization that encounters a situation where standard procedures cannot be followed must file an exception form.
To fill out an exception form, one must provide relevant details about the situation, the reason for the exception, and any supporting documentation.
The purpose of an exception form is to document and approve deviations from standard procedures in a transparent manner.
The exception form must include details about the situation, reason for the exception, impact of the deviation, and any supporting documentation.
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