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APPLICATION FOR EMPLOYMENT An Equal Opportunity Employer CITY OF ASTORIA Human Resources Department 1095 Duane Street Astoria OR 97103 (503)3255824 FAX (503)3252017 We hire and promote without regard

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How to fill out 1095 Duane Street:

1. Start by gathering all the necessary information, such as your full name, address, and Social Security Number.
2. Ensure that you have the correct form, as there are different versions of Form 1095 depending on your circumstances (1095-A for the Marketplace, 1095-B for insurance providers, or 1095-C for employers).
3. Carefully review the instructions provided with the form to understand what information needs to be accurately filled out.
4. Begin by entering your personal information, including your name, address, and Social Security Number in the designated fields.
5. If you are receiving the form from an employer or insurance provider, carefully verify the accuracy of the information provided, such as the dates of coverage and any dependents listed.
6. If you have more than one form (e.g., if you had multiple employers or health insurance providers), ensure that each form is filled out correctly and that the information matches.
7. Attach any additional documents or explanations as required by the instructions. For instance, you may need to provide proof of coverage or country of origin.
8. Review the completed form for any errors or missing information. Make sure all the relevant fields are filled out accurately.
9. Finally, sign and date the form where indicated, certifying that the information you provided is correct to the best of your knowledge.
10. Keep a copy of the completed form for your records before submitting it to the appropriate entity.

Who needs 1095 Duane Street?

1. Individuals who have received Form 1095-A, which provides information about insurance coverage through the Marketplace.
2. Individuals who have received Form 1095-B, which is provided by insurance providers to report health insurance coverage.
3. Individuals who have received Form 1095-C, which is provided by employers who are required to offer health insurance coverage to their employees.
4. Those who need to report their health insurance coverage correctly on their federal tax return.
5. Anyone who is eligible for premium tax credits or other tax benefits related to health insurance coverage.
6. Individuals who are under the obligation to submit Form 1095 in accordance with the Affordable Care Act (ACA) provisions.

Please note that it is always recommended to consult a tax or legal professional when filling out any official forms to ensure accuracy and compliance with applicable regulations.

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