Jacksonville Florida Información para el método alternativo de contar la cobertura acreditable - Information for Alternative Method of Counting Creditable Coverage
Category:
State:
Multi-State
City:
Jacksonville
Control #:
US-334EM
Format:
Word
Instant download
Description
Este formulario es utilizado por una entidad para solicitar información adicional para determinar la cobertura de un individuo con respecto a una categoría de beneficios.
Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés.
For your convenience, the complete English version of this form is attached below the Spanish version.
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