Declaration of Tax Status You must complete and submit this form with your enrollment form when enrolling an individual on your PEBB coverage who does not qualify as your dependent for tax purposes (for example, a state- - Enrollment Act - Document - PDFSEARCH.IO

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	Declaration of Tax Status You must complete and submit this form with your enrollment form when enrolling an individual on your PEBB coverage who does not qualify as your dependent for tax purposes (for example, a state- Add to Reading List Document Date: 2014-10-02 14:01:08 Open Document File Size: 221,80 KB Share Result on Facebook City Olympia / / Company HCA / Registered Domestic Partners / / Currency USD / / Event Layoffs / / IndustryTerm federal law / state law / health insurance / insurance / / Organization Washington State Health Care Authority / Internal Revenue Service / Medicare / / / Position tax advisor / Governor / reasonable attorney / / ProvinceOrState Washington / / URL www.hca.wa.gov / www.irs.gov / / SocialTag United States National Health Care Act Government Health insurance United States Income tax in the United States Flexible spending account Taxation in the United States Social Security Medicare

Declaration of Tax Status You must complete and submit this form with your enrollment form when enrolling an individual on your PEBB coverage who does not qualify as your dependent for tax purposes (for example, a state-Add to Reading List