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Exhibit 5-4: **Sample ** Certification for Qualified Long-Term Care Insurance Expenses
ICR 202502-2502-006 · OMB 2502-0204 · Object 152416100.
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Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Exhibit 5-4: **Sample ** Certification for Qualified Long-Term Care Insurance Expenses |
| Author | H05232 |
| File Created | 2025-09-24 |
| Conversion State | partial |