Get Domestic Partner Affidavit Form - New Hampshire Institute Of Art - Nhia

This guide provides clear and supportive instructions for completing the Domestic Partner Affidavit Form required by the New Hampshire Institute of Art. This essential document specifies the legal partnership status and ensures eligibility for associated benefits.

Follow the steps to complete the Domestic Partner Affidavit Form online.

1. Click ‘Get Form’ button to obtain the Domestic Partner Affidavit Form and open it in your preferred online editor.
2. In the first section, 'Declaration,' both the employee and domestic partner should print their names clearly as designated. This certification confirms that they are domestic partners eligible for NHIA benefits.
3. Next, move to the 'Status' section where both parties must attune to the eligibility requirements listed. Read each criterion carefully and indicate your compliance by confirming each statement as applicable.
4. In the subsequent points, ensure to provide accurate and truthful answers to statements regarding your domestic partnership status, such as your relationship's exclusivity, joint residence, and financial responsibilities.
5. If applicable, attach any required documentation that reflects your shared financial responsibilities. Common documents include copies of tax returns, mortgages, leases, or titles.
6. Proceed to the 'Change in Domestic Partnership' section. Acknowledge the need to report any changes in status to the NHIA Human Resources Department within thirty days.
7. In the 'Statement of Confidentiality,' understand that your information will be kept confidential and will only be shared with necessary parties, such as the healthcare carrier.
8. In the 'Acknowledgements' section, read through the implications of providing false statements. Both parties must affirm that the information provided is true to the best of their knowledge.
9. Finally, both the employee and domestic partner should sign and date the form at the designated spaces, ensuring both names and addresses are correctly printed.
10. After completing the form, save your changes, download it for your records, and print a copy if needed. Ensure you share it with relevant parties as required.

Complete your Domestic Partner Affidavit Form online today to ensure you and your partner receive the necessary benefits.