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Printable Form 8965 New Orleans Louisiana: What You Should Know

This form will help determine whether you qualify for a Marketplace-granted coverage exemption and, if so, to which state or territories you are eligible. To use the free e-file service, you must certify under penalty of perjury that you have not previously filed a tax return that contains false information and that all returns that you, your spouse, or some other individual were required to file for the 2023 Tax Year are accurate. This form must be filed with the Louisiana Department of Revenue within 45 days of the due dates, which you determine without reference to extensions. You may file this form electronically through eFile.com. Instructions for Form 8965—Tax-Filing Requirements 17 Apr 2018— Form 8965—Form 8965 to report the coverage exemption for people who do not have individual income tax reporting exemptions under section 6015(d) or (g). 4 Nov 2017— Form 8965—Form 8965 to report a coverage exemption (exemptions) under section 6015(c) or (d). 28 Oct 2017—Form 8801—Application for Marketplace Eligibility for Coverage. 7 Feb 2016— Form 8801—Application for Marketplace Eligibility to receive a coverage exemption. 20 Jan 2016— Form 888—Application for Coverage of an individual and for exemptions. 4 Sep 2015— Form 8801—Application for Marketplace Eligibility for Coverage. 24 Aug 2014— Form 888—Form 888 Application Form for Marketplace Insurance if an individual and their spouse live in a dwelling (other than a non-home dwelling such as a vacation home) and: (1) one spouse resides in a dwelling separate and apart from the other spouse as a result of domestic duties performed as a teacher; (2) the other spouse is a resident or employee of a qualified nonprofit organization that provides health care services to individuals under a contract of service with the State of Louisiana; or (3) the other spouse is a qualified individual with a qualifying illness (for Medicaid purposes) or disability (Federal Medicaid and CHIP programs). 20 Oct 2013—Form 8889—Enrollment and Coverage in the Louisiana Medicaid and CHIP Health Insurance Marketplace. 20 Sep 2013—Form 8887—Form 8887 for a non-U.S. citizen and non-Citizen or foreign national who would be eligible for a Coverage or Coverage Exception for purposes of the Marketplace. 10 Sep 2013—Form 8885—Form 8885 for a qualified domestic partner and their minor children.

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