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MARCH 1, 2003 Broker's Name Surplus Line License Number D.B.A. Federal Tax I.D. No. (Doing Business As) EFT Taxpayer I.D. No. Mailing Address Method of Tax Payment City, State, Zip No Payment Telephone Number If New Broker, check here If Name Change, check here Check EFT If Final Return, check here STATEMENT OF CALIFORNIA TAXABLE NONADMITTED PREMIUMS On policies/certificates and endorsements transacted by the broker filing this return. from JANUARY 1, 2002 TO DECEMBER 31, 2002 CDI.

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You can check the status of your California State tax refund online at the California Franchise Tax Board website. You will need to know the primary Social Security Number, complete mailing address, and the exact amount of your anticipated refund.

ing to Covered California's official guidelines, “Your Modified Adjusted Gross Income is your Adjusted Gross Income (found on your tax return) plus any tax-exempt Social Security, tax-exempt interest, and tax-exempt foreign income you have.”

Costly repayments: Your account will be in arrears if you pay a lower premium despite your income change. This means you will be liable to pay back the insurer. Legal consequences: Failing to report an income change is considered fraud and, as such, you may face criminal consequences.

By Jan. 31 of each year, Covered California sends the federal IRS form 1095-A Health Insurance Marketplace statement to members. This form is used to: Provide information for your federal taxes.

When you file your taxes, if your income is less than what you told us on your application, you may receive a credit or refund. If your income is more than what you told us on your application, you may have to repay some or all of the advanced premium tax credits that you got.

If you qualify for premium assistance, you must file taxes for the year you get premium assistance. Please tell us about the health insurance you have now. Answer these questions for everyone who needs help paying for health insurance.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232