Form 8965 (New) – Health Coverage Exemptions & Shared Responsibility Payment

Beginning in 2014, individuals must have health care coverage, have a health coverage exemption, or make a shared responsibility payment with their tax return.  Use Form 8965 to report a coverage exemption granted the Marketplace (also called the “Exchange”) or to claim a coverage exemption on your tax return.

http://www.irs.gov/pub/irs-pdf/f8965.pdf

Form 8965 Instructions:  i8965–dft