New York State Requires Specific Documentation For Enrollment in NYSHIP Health (Empire Plan or HMO) and or Dental Plans In addition to completing the PS-404 enrollment form, you must provide written documents to support - Individual Taxpayer Identification Number - Document - PDFSEARCH.IO

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	New York State Requires Specific Documentation For Enrollment in NYSHIP Health (Empire Plan or HMO) and/or Dental Plans In addition to completing the PS-404 enrollment form, you must provide written documents to support Add to Reading List Document Date: 2015-02-26 11:22:16 Open Document File Size: 331,34 KB Share Result on Facebook City Ithaca / / Country United States / / / Facility East Hill Office Building / / IndustryTerm bank statement / / Organization New York State Department / Civil Service / / / Position County Registrar / / ProvinceOrState New York / / SocialTag Government Security Vital statistics Individual Taxpayer Identification Number Internal Revenue Service Birth certificate Passport Taxpayer Identification Number Social Security number Taxation in the United States

New York State Requires Specific Documentation For Enrollment in NYSHIP Health (Empire Plan or HMO) and/or Dental Plans In addition to completing the PS-404 enrollment form, you must provide written documents to support Add to Reading List