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C CONTINUATION GROUP COVERAGE CONSOLIDATED OMNIBUS BUDGET RECONCILIATION ACT COBRA PERS-HBD-85 Rev 5/89 PERS USE ONLY DOCUMENT REFERENCE NUMBER PUBLIC EMPLOYEES RETIREMENT SYSTEM Office of Employer and Member Health Services P. O. Box 942714 Sacramento CA 94229-2714 888 CalPERS 225-7377 TDD - 916 795-3240 FAX 916 795-1277 INSTRUCTIONS FOR COMPLETING THIS FORM ARE ON THE REVERSE SIDE* PLEASE TYPE PART A 1. Type of Action 1 NEW 1 Change ORIGINAL QUALIFYING EVENT AND DATES 2. QUALIFYING EVENT...
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What is persw hbd 85?
Persw HBD 85 is a form used for reporting specific information related to housing benefits and services.
Who is required to file persw hbd 85?
Individuals or entities that provide housing benefits or services, and are mandated by law or regulation to report this information, are required to file persw hbd 85.
How to fill out persw hbd 85?
To fill out persw hbd 85, gather the required documentation, complete all relevant sections accurately, and provide any necessary supporting information as instructed in the form guidelines.
What is the purpose of persw hbd 85?
The purpose of persw hbd 85 is to ensure compliance with housing benefit regulations and to maintain accurate records of housing services provided.
What information must be reported on persw hbd 85?
Persw hbd 85 must report details such as the identity of the service provider, types of housing services offered, beneficiary information, and any financial details relevant to the benefits.
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