Get Statement Of Identity For Children Under 16 Years Of Age, F-10154. Statement Of Identity For

This guide provides detailed instructions on how to accurately complete the Statement of Identity for Children Under 16 Years of Age, F-10154 form. This form is essential for verifying identity for health services like Medicaid and BadgerCare Plus.

Follow the steps to fill out the form correctly.

1. Click the ‘Get Form’ button to obtain the form and open it in your preferred editing software.
2. Begin by listing all children under age 16 in your household for whom you are a parent, guardian, or caretaker relative. This section requires you to write the child's full name including first name, middle initial, and last name.
3. For each child listed, include their date of birth. Be sure to enter this information in a clear format to avoid any errors.
4. Next, for each child, provide their place of birth, including the city, state, and country. Accurate information is essential to satisfy identity proof requirements.
5. Once you have filled in the necessary information for all children, review your entries for accuracy.
6. Sign the statement where indicated, certifying that the information provided is correct and complete to the best of your knowledge.
7. Enter the date on which you are signing the document.
8. Provide your printed name as the parent, guardian, or caretaker relative, ensuring clarity for any necessary follow-ups.
9. Finally, save any changes to the document, and then download, print, or share the filled form as required by your local agency.

Complete your Statement of Identity online to ensure a smooth verification process.