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  • Affidavit For Dependent Parents

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PLEASE PRINT Participant s Name: Participant s SSN# or UID#: (First, Middle, Last Name) (UID# can be found on your BCBS I.D. Card) Dependent s Name: Child s Date of Birth: (First, Middle, Last Name) 1. The Participant is the child s Natural Mother / / Month Day Year Natural Father 2. Does your child reside with you? Yes No If not, with whom doe.

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The dependent's birth certificate, and if needed, the birth and marriage certificates of any individuals, including yourself, that prove the dependent is related to you. For an adopted dependent, send an adoption decree or proof the child was lawfully placed with you or someone related to you for legal adoption.

Affidavit of Dependency means a notarized document that attests that a child meets the criteria in the definition of Dependent Child. Proof of legal guardianship or a signed Affidavit of Dependency will be required for coverage of a grandchild beyond the first 31 days from birth.

I hereby declare true to the best of my knowledge and belief that Smt./Sri. ___________________________________________________ aged _____________ is solely dependent on me and He/She was i.e my Father/Mother was not an employee and not having any source of income either from landed property or by way of any pension.

At any time, contact us here at eFile.com or call the IRS support line at 1-800-829-1040 and inform them of the situation.

Who are dependents? Dependents are either a qualifying child or a qualifying relative of the taxpayer. The taxpayer's spouse cannot be claimed as a dependent. Some examples of dependents include a child, stepchild, brother, sister, or parent.

I, ID number hereby declare that I am the parent of the person in the table and that ____________________________________________ (insert name of main member) is factually and otherwise responsible for him/her and wants to add him/her as a dependant on my membership of GEMS. Please select the appropriate block.

Related Definitions Dependent Parents means Your father or mother who are financially dependent on You.

I hereby declare true to the best of my knowledge and belief that Smt./Sri. ___________________________________________________ aged _____________ is solely dependent on me and He/She was i.e my Father/Mother was not an employee and not having any source of income either from landed property or by way of any pension.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232