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REDEVELOPMENT AUTHORITY OF THE COUNTY OF BERKS Majors SYSTEMS PROGRAM APPLICATION Applicants Name (s):Age:Address:/Phone #:S.S.#:(1)S.S.#:(2)Email Address: Is this your principal residence? Yes No

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What is msp application-intake form?

The MSP application-intake form is a document used by individuals to apply for the Medical Services Plan (MSP) coverage, which provides health insurance in certain regions.

Who is required to file msp application-intake form?

Individuals who are new residents, returning residents, or those who have experienced a change in their eligibility for MSP coverage are required to file the MSP application-intake form.

How to fill out msp application-intake form?

To fill out the MSP application-intake form, individuals must provide personal information such as their name, address, date of birth, and details about their residency. It's important to follow the instructions carefully and ensure all required fields are completed.

What is the purpose of msp application-intake form?

The purpose of the MSP application-intake form is to assess an individual's eligibility for medical services coverage under the MSP program and to facilitate the enrollment process.

What information must be reported on msp application-intake form?

The MSP application-intake form requires information such as the applicant's full name, date of birth, contact information, residency status, and details of dependents, if any.

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