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Begin with Part I, where you will enter the names and Social Security Numbers (SSNs) of individuals who have received a Marketplace-granted coverage exemption. Ensure you also include the Exemption Certificate Number for each individual.
Proceed to Part II if you are claiming a coverage exemption based on your household income. Simply check the box indicating that your income is below the filing threshold.
In Part III, list any additional individuals in your tax household claiming an exemption. Fill in their names, SSNs, and specify the type of exemption along with the months they were covered.
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