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Get 0938 1191

Tion by email? Yes No Email address: 17. What is your preferred spoken or written language (if not English)? 18. Do you need health coverage for yourself? Yes. If yes, answer all the questions below. No. If no, skip to Step 2 on page 2. (Leave the rest of this page blank) 19. Social Security number - We need Social Security numbers (SSNs) for anyone who wants coverage. We use SSNs to verify citizenship. For help getting an SSN, visit socialsecurity.gov or call 1-800-772-1213. TTY user.

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