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RI Executive Office of Health and Human Services Medicaid ProgramSEQ # NOTIFICATION ID NAME ADDRESS CITY, STATE ZIPDATE LAST 4 DIGITS OF THE MEMBER#Dear Name: You applied to get health and drug coverage

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What is you applied to get?

You applied to get a specific application or form related to a government benefit, loan, or service.

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Individuals or entities who meet the eligibility criteria set forth in the application guidelines are required to file.

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To fill out the application, provide accurate personal information, complete all required sections, and submit any necessary supporting documents.

What is the purpose of you applied to get?

The purpose is to request consideration for a specific benefit, service, or loan offered by an organization or government agency.

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Typically, you must report personal identification details, income information, and any other relevant data required by the form.

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