Common Contracts

2 similar Individual Mandate Agreement contracts

Contract
Individual Mandate Agreement • January 30th, 2019

INDIVIDUAL MANDATE OFFICIAL USE ONLY PIF #: Date opened: Please read the agreement below carefully and indicate acceptance by signing in the space(s) provided below.

Contract
Individual Mandate Agreement • January 30th, 2019

INDIVIDUAL MANDATE OFFICIAL USE ONLY PIF #: Date opened: Please read the agreement below carefully and indicate acceptance by signing in the space(s) provided below.