Form REV-1882 Health Insurance Coverage Information Request - Pennsylvania

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Form REV-1882 Health Insurance Coverage Information Request - Pennsylvania

What Is Form REV-1882?

This is a legal form that was released by the Pennsylvania Department of Revenue - a government authority operating within Pennsylvania. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form REV-1882?
A: Form REV-1882 is the Health Insurance Coverage Information Request form in Pennsylvania.

Q: Who needs to complete Form REV-1882?
A: Pennsylvania residents who have individual health coverage or who are claiming an exemption from coverage need to complete Form REV-1882.

Q: What information is required on Form REV-1882?
A: Form REV-1882 requires information about the individual health insurance coverage, including the policy number, coverage start and end dates, and the insurance company's name and address.

Q: How do I submit Form REV-1882?
A: Form REV-1882 can be submitted by mail or electronically. Instructions for submission are provided on the form itself.

Q: When is the deadline for submitting Form REV-1882?
A: The deadline for submitting Form REV-1882 is typically April 15th of each year.

Q: What happens if I don't submit Form REV-1882?
A: Failure to submit Form REV-1882 or providing false information may result in a penalty or loss of exemption.

Q: Is there a fee for submitting Form REV-1882?
A: No, there is no fee for submitting Form REV-1882.

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Form Details:

  • Released on July 1, 2021;
  • The latest edition provided by the Pennsylvania Department of Revenue;
  • 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 fillable version of Form REV-1882 by clicking the link below or browse more documents and templates provided by the Pennsylvania Department of Revenue.

Download Form REV-1882 Health Insurance Coverage Information Request - Pennsylvania

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