
IRREVOCABLE FUNERAL CONTRACT CERTIFICATION Michigan Department of Human Services DHS USE ONLY Grantee Name AUTHORITY: P.A. 255 OF 1986. COMPLETION: Voluntary PENALTY: Possible ineligibility for assistance.
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How to fill out the DHS-0008-A online
This guide provides clear instructions on how to complete the DHS-0008-A form online. By following these steps, users can ensure that their application is accurately filled out and submitted efficiently.
Follow the steps to fill out the DHS-0008-A online effectively.
- Press the ‘Get Form’ button to access the document and open it for editing.
- Begin with Section I by entering the date, the name of the contract seller, and the amount for which the funeral contract is guaranteed.
- Indicate whether any amount from the death benefit of a life insurance policy or annuity contract has been assigned as payment for funeral goods or services by checking the appropriate box.
- Provide details for the beneficiary, including their name, Social Security number, address, and birthdate.
- Sign and date the form in the designated areas for the purchaser or beneficiary.
- Proceed to Section II to certify that the funeral contract is fully paid and compliant with Public Act 255 of 1986, providing the name of the contract seller, their address, phone number, registration number, and expiration date.
- The contract seller must then sign and date the form in Section II.
- Finally, wait for the Department of Human Services to review the contract in Section III and indicate approval or disapproval with the signature and date.
- After completing the form, save your changes, and you can choose to download, print, or share the completed document as needed.
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