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Obama Care

INFORMATION REQUIRED FOR FILLING AN APPLICATION TO THE HEALTH CARE REFORM

IN THE MESSAGE BOX, PLEASE TYPE YOUR FULL NAME, DOB, ADDRESS, CITY, STATE, ZIP CODE, PHONE NUMBER, GENDER, MARITAL STATUS, IF YOU WERE BORN IN THE U.S. OR NOT AND IF YOU ARE A CITIZEN OR A PERMANENT RESIDENT.
By submitting the information above, you are accepting that a certified WorldStar insurance Agent processes your application for health insurance.