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Please return the completed form. By Mail: PO Box 1106 Lewiston, ID 83501 By Fax: 1 (877) 3693407Asuris Northwest Health 528 East Spokane Falls Boulevard Suite 301 Spokane, WA 99202Affidavit of Qualifying Incapacitated Dependent Eligibility for Small Group (up to 100) Coverage STATEMENT OF DEPENDENTS ELIGIBILITY (to be completed by the Employee) Employees NameID NumberEmployees AddressGroup NumberCityStateZIP CodeDependents NameDependents BirthdateDependents

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How to fill out by mail po box

01

Obtain a PO Box application from your local post office or online.

02

Fill out the application form with your personal information, including your name, address, and contact number.

03

Choose the size of the PO Box you need based on your expected mail volume.

04

Provide identification, such as a government-issued ID or utility bill, as proof of identity and address.

05

Pay the necessary rental fee for the PO Box, which may vary by size and location.

06

Once your application is processed, you'll receive your PO Box number and keys or access instructions.

07

Start using your PO Box for receiving mail and packages securely.

Who needs by mail po box?

01

Individuals who want to receive mail at a secure location.

02

Businesses that require a postal address separate from their physical location.

03

Travelers or those who frequently move and need a stable mailing address.

04

People who wish to keep their home address private for safety reasons.

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Online sellers or e-commerce businesses needing a reliable place for returns or shipments.

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What is by mail po box?

A by mail PO Box is a private mailbox rental service that allows individuals or businesses to receive mail at a secured location instead of a traditional street address.

Who is required to file by mail po box?

Individuals or businesses that prefer a secure mailing address or those who need to maintain privacy regarding their physical address may choose to file using a by mail PO Box.

How to fill out by mail po box?

To fill out a by mail PO Box application, provide the appropriate identification, specify the desired box number, and complete any necessary forms provided by the mailbox service.

What is the purpose of by mail po box?

The purpose of a by mail PO Box is to provide a secure and private location for receiving mail without disclosing a personal or business address.

What information must be reported on by mail po box?

Information that must be reported on a by mail PO Box includes the name of the renter, physical address, contact information, and identification verification, as required by the mailbox service provider.

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