Get Non-custodial Parent Exemption Form Co-1325 - Osc Ct

Filling out the Non-Custodial Parent Exemption Form CO-1325 is a crucial step for users seeking an exemption from the Health Enhancement Program requirements for children living with a former partner. This guide provides clear, easy-to-follow instructions to help you complete the form online efficiently.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin filling out the member information section. Ensure that all personal details, including your member identification number, group number, employee ID, last name, first name, middle initial, and date of birth, match exactly with what is listed on your medical/dental plan ID card.
3. Complete the non-compliant child section. Provide the last name, first name, middle initial, and date of birth of the child or children for whom you are claiming the exemption.
4. Fill in your home address, including the number and street name, city, state, and zip code. Additionally, provide your telephone number and email address in the designated fields.
5. In the non-custodial parent statement, confirm that the identified children are in the custody of your former partner and that you have made efforts to ensure their compliance with the Health Enhancement Program. Ensure clarity and honesty in your assertions.
6. Attach a copy of your divorce decree or legal separation judgment, which confirms the physical custody of the children to your former partner. This document is crucial for the submission.
7. In the acknowledgement section, sign and date the form to certify that the information provided is true and correct. Remember, your claim for an exemption is subject to verification.
8. Finally, save changes, download, print, or share the completed form as needed to ensure it is submitted properly to the designated office.

Take the first step today by completing your Non-Custodial Parent Exemption Form CO-1325 online.