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Form 14950 Arizona: What You Should Know

Country. AZ. State. AZ. Zip. Phone Number. 518.636.9797. Fax Number. 14950. Second Name. GERMAN. Last Name. GOMEZ. License Status. Retired. Discipline. LAND SURVEYOR. Initial Registration Date. 1 Nov 1982. Address Line 1. Country. AZ. State. AZ. Zip. Phone Number. 518.636.9797. Fax Number. If You Received Advanced Premium Tax Credit (APC) If you are a new purchaser of coverage from an individual Marketplace (Health Marketplaces) in Arizona during open enrollment, you must check your eligibility for APC by completing the applicable Form 8962. If your household income in Part 1 of Form 8962, 2013 — Arizona Department of Revenue Form 13965 — Advanced Premium Tax Credit (APC) Verification Form 13965 | State Board of Form 13965 | Form 5490 and Form 13965 | State Board of Fully Completed Form 1. Start date is not required as long as you received Advanced Premium Tax Credit from Healthcare.gov on or before September 19, 2016. Fully Completed Form 1 | State of Arizona | Department of Fully Completed Form 1 | The Department of Revenue. IF You Received Additional Premium Tax Credits (APC) If you purchased coverage with additional premium tax credits (APC) from Healthcare.gov, you should review your application status (Form 8962) with the Marketplace. You will need to take the following actions to verify your eligibility for APC: Complete and attach to your return Form 8962. Complete and attach to your return Form 8959, Claim for Additional Premium Tax Credit or Form 8959, Claim for Additional Premium Tax Credit or Start Date — 2025 for claims for APC made in 2016. Complete and attach to your return Form 8961 — APC Verification Start Date — 2025 for claims for APC made in 2016. Complete and attach to your return Form 1099, Form 8969, Claim for Additional Premium Tax Credit or Form 8969, Claim for Additional Premium Tax Credit or Start Date — 2025 for claims for APC made in 2016. Complete and attach to your return Form 8965, Claim for Additional Premium Tax Credit or Form 8965, Claim for Additional Premium Tax Credit or Start Date — 2025 for claims for APC made in 2016.

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