Enroll In No-Cost Health Insurance in Less than 1 Minute

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I hereby acknowledge my agreement to the contents of this attestation. By affixing my signature below, I respectfully request
this agent or its agency affiliates to enroll both myself and/or my family in the most optimal $0 ACA plan. Additionally, I authorize them to access my healthcare.gov account and submit the necessary information in accordance with the details provided.

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