Tobacco Surcharge Recommendations a This surcharge will be - uaf 2026

1. Click ‘Get Form’ to open the Tobacco Surcharge Recommendations document in the editor.
2. Begin by reviewing the introductory section, which outlines the purpose of the surcharge and its implications for employees and dependents who use tobacco products.
3. Fill out the 'Non-Tobacco Use Certification' section if you or your dependents do not use tobacco. Ensure all required fields, such as Employee Name, ID, and contact information, are completed accurately.
4. If applicable, complete the 'Certification of Tobacco Cessation Program Participation' section. Indicate your enrollment in any cessation programs and provide dates of enrollment.
5. Review your entries for accuracy. Misrepresentation may lead to penalties. Once confirmed, save your changes.
6. Submit the completed form to your HR office by the specified deadlines for processing.

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