PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
Form BEN065
for the current year.
Form BEN065 Long-Term Care Health Quesionnaire - Alaska
What Is Form BEN065?
This is a legal form that was released by the Alaska Department of Administration - a government authority operating within Alaska. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form BEN065?
A: Form BEN065 is the Long-Term Care Health Questionnaire for the state of Alaska.
Q: Who needs to fill out Form BEN065?
A: Anyone applying for long-term care benefits in Alaska needs to fill out Form BEN065.
Q: What information is required on Form BEN065?
A: Form BEN065 requires information about your personal details, health conditions, medical history, and financial situation.
Q: Why do I need to fill out Form BEN065?
A: Form BEN065 is used to determine your eligibility for long-term care benefits in Alaska.
Form Details:
- Released on December 1, 2009;
- The latest edition provided by the Alaska Department of Administration;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form BEN065 by clicking the link below or browse more documents and templates provided by the Alaska Department of Administration.
Download Form BEN065 Long-Term Care Health Quesionnaire - Alaska
1
2
3
4
