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Exhibit II.I STATE OF NEW YORK DEPARTMENT OF CIVIL SERVICE ALBANY, NEW YORK 12239 EMPLOYEE BENEFITS DIVISION STATEMENT OF DEPENDENCE FOR PARTICIPATION IN THE HEALTH INSURANCE PROGRAM PS-457 (5/06).

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How to fill out the DA 31 form online

The DA 31 form is essential for individuals applying for health insurance coverage on behalf of a dependent child. This guide provides user-friendly, step-by-step instructions to assist you in completing the form accurately in an online format.

Follow the steps to complete the DA 31 form online.

  1. Press the ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering your name in the 'Enrollee’s Name' field. Accurately input your current address, including the street number, city, state, and zip code.
  3. Provide the name of your agency in the designated field if you are currently on the payroll.
  4. Enter the dependent's name and their health insurance identification number.
  5. Indicate your contact information by filling out the telephone number fields for both work and home.
  6. In the 'Dependent’s Birth Date' section, input the birth date of the dependent.
  7. Respond to the question about the relationship of the dependent to you. Specify the relationship clearly.
  8. Declare who has legal custody of the dependent by filling in the appropriate information in the next section.
  9. Check the box to confirm whether you are acting in place of the parent for the dependent and whether you have assumed responsibility for their medical expenses.
  10. Indicate the percentage of the dependent’s support that you provide. Be prepared to supply documentation to support your claim.
  11. When prompted, confirm whether your home is the permanent legal residence of the dependent by checking 'Yes' or 'No,' and provide an explanation if necessary.
  12. Lastly, state how long you anticipate the dependent's legal residence will continue. Specific answers are required for the duration.
  13. Once all fields are filled in, make sure to review the information for accuracy. Save changes, and you can then choose to download, print, or share the completed form as needed.

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To fill out the DA Form 31, begin by entering your personal details, including your name, rank, and unit. Next, specify the type of leave you are requesting and provide the relevant dates. Use clear and concise language to explain your reason for leave, as this will help expedite the approval process.

A DA Form 31 is an official document used by the United States Army to request leave or pass for service members. This form allows soldiers to formally communicate their need for time away from duty. Understanding the DA 31 Form is crucial for ensuring that your leave is approved without any issues.

To fill out the DA 31 Form, start by entering your personal details, including your full name, rank, and unit. Next, specify the dates of your requested leave and the reason for your absence. If you need assistance, platforms like USLegalForms provide easy-to-follow instructions and templates for completing the DA 31 Form accurately.

Filling out the DA 31 Form involves providing your personal information, detailing the leave dates, and stating the purpose of your leave. It's important to ensure that all sections are completed accurately to avoid delays in approval. Resources like USLegalForms offer templates and guidance to help you fill out the DA 31 Form correctly.

Any active duty soldier, reservist, or National Guard member who wishes to take leave must fill out the DA 31 Form. This applies to all ranks and positions within the Army. Completing the DA 31 Form ensures that all requests are processed efficiently and in accordance with military guidelines.

Yes, the DA 31 Form is still valid and remains a crucial document for soldiers seeking leave. It is essential to use the most current version of the form to ensure compliance with Army regulations. Utilizing the DA 31 Form helps streamline the leave process and ensures proper record-keeping within the military.

The DA Form 31 is primarily used by members of the U.S. Army to request leave or pass from duty. This form helps soldiers formally communicate their leave intentions to their superiors. By submitting a DA 31 Form, soldiers ensure they follow the proper protocol for taking time off, which is essential for maintaining operational readiness.

To complete a DA 31 form, start by filling in your personal information, including your rank, unit, and the dates of your requested leave. Next, clearly state the reason for your absence, ensuring you provide all necessary details. After completing the form, submit it to your chain of command for approval. For step-by-step assistance and templates, consider visiting US Legal Forms, which offers comprehensive resources for navigating the DA 31 form process.

The purpose of the DA 31 form is to authorize military leave; document the start and stop of such leave; record address and telephone number where a soldier may be contacted in case of an emergency during leave; and certify leave days chargeable to a soldier's leave account.

0:53 2:46 How to Fill Out DA Form 2823 (Sworn Statement) | PDFRun - YouTube YouTube Start of suggested clip End of suggested clip Also the bottom of each additional page must bear the initials of the person making the statement.MoreAlso the bottom of each additional page must bear the initials of the person making the statement. Along with the page. Number for the affidavit.

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© Copyright 1997-2026
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
Your Privacy Choices
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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
altaFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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 1997-2026
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232