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This version of the form is not currently in use and is provided for reference only. Download this version of
Form BEN065
for the current year.
Form BEN065 Long-Term Care Health Quesionnaire - Alaska
What Is Form BEN065?
This is a legal form that was released by the Alaska Department of Administration - a government authority operating within Alaska. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form BEN065?A: Form BEN065 is the Long-Term Care Health Questionnaire for the state of Alaska.
Q: Who needs to fill out Form BEN065?A: Anyone applying for long-term care benefits in Alaska needs to fill out Form BEN065.
Q: What information is required on Form BEN065?A: Form BEN065 requires information about your personal details, health conditions, medical history, and financial situation.
Q: Why do I need to fill out Form BEN065?A: Form BEN065 is used to determine your eligibility for long-term care benefits in Alaska.
Form Details:
- Released on December 1, 2009;
- The latest edition provided by the Alaska Department of Administration;
- 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 printable version of Form BEN065 by clicking the link below or browse more documents and templates provided by the Alaska Department of Administration.
Download Form BEN065 Long-Term Care Health Quesionnaire - Alaska
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