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Get Application For Exemption - Tribe - Health Insurance Marketplace ...
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How to fill out the application for exemption - tribe - health insurance marketplace online
This guide provides clear and supportive instructions on how to fill out the application for exemption from the shared responsibility payment for American Indians and Alaska Natives. By following these steps, you can complete the form online with confidence.
Follow the steps to complete your application online.
- Press the ‘Get Form’ button to access the application and open it in a suitable editor.
- Fill out your contact information, including your first name, last name, and address information. Ensure to provide a phone number and an email address if you wish to receive updates about your application.
- Indicate your preferred language and provide any necessary documentation about tribal membership or eligibility for health services. Be sure to include social security numbers for those applicable.
- List each person in your tax household who is requesting an exemption. This includes adults and dependents, but not dependents who are not seeking the exemption for themselves.
- Complete the information for each person in the tax household by including their date of birth, sex, and social security number if available. Answer eligibility questions related to tribal membership or eligibility for health care services.
- Sign and date the application, certifying that the information provided is true and complete to the best of your knowledge.
- Mail the completed application and any supporting documents, including tribal membership proof, to the specified address. Ensure you keep copies for your records.
Complete your application for exemption online today!
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Most tribes require a specific percentage of Native blood, called blood quantum, in addition to being able to document which tribal member you descend from. Some tribes require as much as 25% Native heritage, and most require at least 1/16thNative heritage, which is one great-great grandparent.
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