Get Absent-parent Questions And Assignment Of Rights (ap-1) - Mass.gov - Mass

This guide provides comprehensive instructions for filling out the Absent-Parent Questions And Assignment Of Rights (AP-1) form required for certain MassHealth applications. Designed to assist users with varying levels of legal knowledge, this guide will walk you through each section of the form to ensure clarity and completeness.

Follow the steps to successfully complete the AP-1 form.

1. Press the ‘Get Form’ button to access the Absent-Parent Questions And Assignment Of Rights (AP-1) form and open it in your preferred environment.
2. Begin by carefully reading Part A, which outlines the requirement to cooperate with the Child Support Enforcement Division of the Massachusetts Department of Revenue for obtaining benefits. Familiarize yourself with the implications of 'Good Cause' as mentioned in this section.
3. In the Head of Household Section, provide your last name, first name, middle initial, MassHealth ID (or Social Security Number if you do not have a MassHealth ID), date of birth, telephone number, and mailing address if it differs from your street address.
4. List information for each child in the household. Include their last name, first name, and date of birth. If there are more children, ensure you have space to provide their details.
5. Proceed to Part B if applicable. Document the names of any children who have been adopted by a single parent or have an absent parent who is deceased or unknown.
6. If there is a reason for not cooperating with the absent parent's information, complete Part C—Good Cause—by responding 'yes' or 'no' and providing the necessary details regarding the children and applicable reasons.
7. Complete Part D with information about the absent parent(s), including their name, Social Security Number, date of birth, gender, relationship to the child, any medical-support orders, and other pertinent details.
8. Sign Part E to certify that you are the custodial parent or legal guardian, ensuring all provided information is accurate to the best of your knowledge.
9. After reviewing your completed form for accuracy, save, download, print, or share the document as required.

Complete your Absent-Parent Questions And Assignment Of Rights (AP-1) form online today for a smoother application process.