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P.O. Box 71107 Oakland, CA 94612 1.800.617.4729 1.888.410.7361 www.sterlingadministration.com HEALTH REIMBURSEMENT ARRANGEMENT ACCOUNT CHANGE OR TERMINATION FORM Date: Company Name: Employer ID Number:
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How to fill out relationship to date of:

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Start by entering the details of your relationship. This could include whether you are currently married, divorced, separated, or in a domestic partnership.
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Specify the date of your relationship. This could be the date of your marriage, divorce, or the start of your domestic partnership.
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If you are divorced or separated, provide the date of your divorce or separation.
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If you are in a domestic partnership, provide the date of the start of your partnership.
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Include any additional information that may be required, such as the court where your divorce was finalized or the state where your domestic partnership was registered.

Who needs relationship to date of:

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Relationship to date of is the connection or association between two individuals or entities up to a specific date.
Individuals or entities who have a financial or personal connection up to a specific date are required to file relationship to date of.
To fill out relationship to date of, one must provide accurate and detailed information about the nature of the relationship, the parties involved, and the relevant dates.
The purpose of relationship to date of is to document and disclose any significant connections or associations between individuals or entities up to a specific date.
On relationship to date of, one must report details such as the nature of the relationship, the parties involved, any financial transactions or agreements, and the specific date up to which the relationship is being disclosed.
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