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Esta es una solicitud para recibir asistencia financiera (también denominada "beneficencia") en UW Medicine. El estado de Washington.Cómo solicitar Cómo se reciben los fondos ¿Quién es elegible? Solicitud de cambio en la tasa de recuperación de sobrepago. Si usted desea solicitar un nuevo pasaporte, también deberá llenar el Formulario DS-64 (en inglés) y entregarlo junto con su solicitud. El reclamante debe completar el formulario en el sitio web de la aseguradora o del administrador y enviarles el formulario directamente. Registrar Solicitud de Recuperación de Nacionalidad . NO se aceptan formularios de solicitud llenados a mano. No firme la solicitud hasta que se lo solicite un funcionario consular. Una DCH-1426, Solicitud de Cobertura de Salud y Ayuda para.