Get 4931 87e 2020-2026

The 4931 87e form is an essential document used for requesting a re-assessment of your Trillium Drug Program annual deductible. This guide will provide clear, step-by-step instructions to help you complete the form accurately and efficiently online.

Follow the steps to fill out the 4931 87e form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Review the qualification criteria in Section 1 to ensure you meet all four requirements before proceeding.
3. In Section 2, all household members aged 18 and older must complete the declarations. Ensure each person provides their signature and date.
4. For Section 3, either refer to your 2015 Notice of Assessment as proof of income or complete the monthly income worksheet for each household member over 18, outlining expected income for each month in 2015.
5. In Section 4, gather and attach necessary supporting documentation based on the types of income received by household members. Ensure all documents are included to prevent the request from being declined.
6. Review all sections for completeness and accuracy before submitting the form. Make sure all information is correct and that all required signatures are provided.
7. Finally, save your changes, then download, print, or share the completed form as necessary before sending it to the Trillium Drug Program at the provided address.

Begin your application process by completing the 4931 87e form online today.