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PO Box 4649, Portland, OR 9720846492024 Washington Individual & Family Change Form This form is for current Providence Health Plan Individual & Family Policyholders. Changes to your Providence Health
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What is this form is for?
This form is for reporting financial information to the IRS.
Who is required to file this form is for?
Certain individuals and businesses are required to file this form.
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The form can be filled out online or submitted through mail.
What is the purpose of this form is for?
The purpose of this form is to ensure compliance with tax laws.
What information must be reported on this form is for?
Income, deductions, and credits must be reported on this form.
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