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Get Canada HLTH 119 2012

Er party. This authorization is valid for the taxation year prior to the signature of this application, the year of the signature and for each subsequent consecutive taxation year for which premium assistance is requested. It may be revoked by sending a written notice to Health Insurance BC. I have resided in Canada as a Canadian citizen or holder of permanent resident status (landed immigrant) for at least the last 12 months immediately preceding this application; I am not exempt from liability.

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