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Retiree Enrollment & Change Form Local 70 Health & Welfare Office 400 Roland Way Oakland, CA 94621 (855) 2637242 (925) 8337301 FAX INSTRUCTIONS: (Please read carefully before completing this form)

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Individuals who are applying for enrollment in the IFP (Individuals and Families Program) may need to fill out the m-23-055-2024-ifp-enrollment-formpdf.

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