Get Da 31 Form

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.

Complete your documents online with ease and confidence.