State Of Hawaii Form Hc 5

State Of Hawaii Form Hc 5 - Completed, signed form on file for 2 years. The employee’s selection below is applicable only within calendar year 2025. •works for 2 or more employers** or •claims an exemption.

Completed, signed form on file for 2 years. •works for 2 or more employers** or •claims an exemption. The employee’s selection below is applicable only within calendar year 2025.

•works for 2 or more employers** or •claims an exemption. Completed, signed form on file for 2 years. The employee’s selection below is applicable only within calendar year 2025.

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The Employee’s Selection Below Is Applicable Only Within Calendar Year 2025.

Completed, signed form on file for 2 years. •works for 2 or more employers** or •claims an exemption.

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