Get Mdad Damaged Id Badge Application 01.10.07.doc

Filling out the MDAD Damaged ID Badge Application is an important step for obtaining a replacement identification badge. This guide provides clear, step-by-step instructions to help you complete the application accurately and efficiently.

Follow the steps to fill out your application correctly.

1. Click the ‘Get Form’ button to access the application. This action will enable you to download and open the form in your preferred online editor.
2. Begin by filling out Section I, labeled 'Badge Holder'. Input your Social Security Number, Date of Birth in MM/DD/YYYY format, First Name, Middle Name, Last Name, Height, Hair Color, Gender, Weight, Eye Color, Race, Title, Home Phone Number, Country of Birth (specifying city and state if applicable), Home Address, City/State/Zip, Aliases or Nicknames. Indicate your citizenship status by marking the options for U.S. Citizen, U.S. Passport Number, U.S. Resident, Non-Immigrant Authorized to Work, and provide your Alien Resident Number if applicable.
3. In Section II, titled 'Reason for Replacement', indicate whether your badge was damaged, lost, or if you are requesting a title or name change. Provide details as required.
4. Complete the applicant’s signature section, ensuring to include your signature and the date. Please be aware that providing false information can lead to legal consequences.
5. Section III is to be completed by your employer. They will fill out the Company Name, Company Code, Authorized Representative details, and provide their signature and date.
6. After completing all sections, carefully review the form to ensure all areas have been filled in correctly. Make sure there are no alterations or corrections, as these can lead to rejection.
7. Finally, save your changes, and you may choose to download, print, or share the completed form as necessary.

Take action now and fill out the MDAD Damaged ID Badge Application online for a smooth replacement process.