Get Phs 1637 1 Form

The PHS 1637 1 form, officially known as the Public Health Service Commissioned Officer’s Request for Dependency Determination, is a crucial document for individuals seeking to establish or re-certify dependency status. This guide provides step-by-step instructions on how to effectively fill out this form online.

Follow the steps to complete the PHS 1637 1 form online

1. Click ‘Get Form’ button to obtain the PHS 1637 1 form and open it in your document editor.
2. Complete the heading section with your Social Security number, full name (last, first, middle initial), date of last entry on active duty, pay grade, current duty station, and appropriate telephone number.
3. In the purpose section, select whether you are establishing initial dependency or re-certifying dependency status by checking the corresponding box.
4. Provide marital status by indicating whether you are married or single. If married, input the date and place of your present marriage.
5. List the names, addresses, and dates of birth for each dependent. If applicable, provide details for claimed adopted children, including adoption date and court address.
6. If there are children not in your legal custody, fill in the name and address of the legal custodian and specify the monthly contribution you provide for their support.
7. If claiming dependents other than your spouse or children under 21, fill out their details including monthly contributions, income from other sources, and monthly expenses.
8. Confirm whether or not you have claimed any dependents on your Federal Income Tax return for the past year and provide reasons if any dependents were not claimed.
9. If applicable, complete the section for unmarried children over 21 who are either physically or mentally handicapped by attaching the necessary physician’s statement.
10. Finally, ensure to sign and date the form. Include a note to notify the relevant office of any changes in dependency status.
11. Once all sections are filled out, review the document for accuracy, then proceed to save changes, download, print, or share the form as needed.

Complete the PHS 1637 1 form online to ensure accurate dependency determination.