How To Cms-l564 Form PDF Converter online?
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What is Cms-l564 Form?
Form CMS-L564 is an employment information form from the Social Security Administration (SSA). It's used in conjunction with Form CMS-40B when you apply for Medicare part B during a special enrollment period (SEP). One portion is completed by you and the other is completed by your employer or your spouse's employer.12 Dec 2019
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- Place your signature and date.
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