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2. Application: (First Choice) :
                          Fill out   “(VISION) Application Form “

               3..    Benefit
                         Employee (only) : 0% and ACI: 100%

               4.    Vision Benefit Declination
                         Fill out:  “ (VISION) Insurance Declination  Form (Decliner only) “

        Thank you,
        Wishing you and your family a very Merry Christmas and a Happy New Year !


































































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