This is a legal form that was released by the Court of Common Pleas - Franklin County, Ohio - a government authority operating within Ohio. The form may be used strictly within Franklin County. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form E5215?
A: Form E5215 is a Health Insurance Affidavit used in Franklin County, Ohio.
Q: What is the purpose of Form E5215?
A: The purpose of Form E5215 is to verify an individual's health insurance coverage.
Q: Who needs to fill out Form E5215?
A: Any individual who is a resident of Franklin County, Ohio and is required to provide proof of health insurance coverage.
Q: Is Form E5215 mandatory?
A: Yes, if you are a resident of Franklin County, Ohio and are required to provide proof of health insurance coverage, you must fill out and submit Form E5215.
Q: What information do I need to provide on Form E5215?
A: You will need to provide your personal information, including your name, address, social security number, and information about your health insurance coverage.
Q: Are there any penalties for not filling out Form E5215?
A: Failure to submit Form E5215 or providing false information may result in penalties, including loss of eligibility for certain benefits.
Q: When do I need to submit Form E5215?
A: You should submit Form E5215 as soon as possible if you are required to provide proof of health insurance coverage.
Form Details:
Download a fillable version of Form E5215 by clicking the link below or browse more documents and templates provided by the Court of Common Pleas - Franklin County, Ohio.