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Get Form Health Payment 2016-2024

Nt coupon if you received a notification letter from the IRS stating you have successfully enrolled in the HCTC Program. Step 1: Complete the information requested in the spaces provided directly below. You can find your HCTC Participant Identification Number at the top of your enrollment notification letter. We strongly recommend that you complete Step 1 prior to printing, as it will auto-populate the coupon below. Electronic completion of this form will assist with the accurate and timely proc.

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