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CA 3853 page 2

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There are two available fields to enter coverage and/or exemption codes for each month in January through December for each individual. Enter one coverage or exemption code per field.

 

Coverage Code

Enter Z, if you and/or another member of your applicable household is considered to have MEC for any, or all, months in 2020/2021 enter coverage code

"Z""in Part III on form FTB 3853.

Exemption Code

The list of exemption codes is in the F1 help under CA codes

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