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Get Fl 478 Info Form 2007-2024

E instructions to complete the Request and Notice of Hearing Regarding Health Insurance Assignment (form FL-478) if you do not have an attorney representing you. Your attorney, if you have one, should complete this form. You must file the completed Request and Notice of Hearing form and its attachments with the court clerk within 15 days after the date your employer gave you a copy of Application and Order for Health Insurance Coverage (form FL-470) or National Medical Support Notice (form OMB-0.

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