Get Dcss 0054

The Dcss 0054 form is essential for providing health insurance information related to child support services in California. This guide will assist you in completing the form accurately and submitting it effectively online.

Follow the steps to successfully complete the Dcss 0054 online.

1. Click the ‘Get Form’ button to obtain the form and open it in your preferred online editor.
2. Begin by entering the county where the case is being handled, along with the Local Child Support Agency (LCSA) case number.
3. Fill in the noncustodial parent's full name and address, ensuring all details are correct and complete.
4. Select whether you are the custodial party or the employer, and provide your city, state, and zip code.
5. Input the noncustodial parent's phone number and social security number.
6. Complete SECTION I by indicating if health insurance is currently provided through the noncustodial parent or employer.
7. If health insurance is available, provide the insurance company's name, address, and your relationship to the insured.
8. Enter the health insurance policy number, premium amount, and specify how often the premiums are paid.
9. List the dependents currently covered by the health insurance, providing their names and relevant details.
10. If applicable, repeat the process for dental and vision insurance, filling in the respective sections.
11. Proceed to SECTION II to provide information about the other parent's insurance coverage, if any.
12. For SECTION III, indicate whether coverage information is enclosed, unavailable, or will be provided later.
13. Sign and date the completed form, ensuring your printed name and telephone number are also included.
14. Finally, review all information for accuracy before proceeding to save your changes, download, print, or share the form as needed.

Complete your Dcss 0054 form online today to ensure accurate health insurance information is submitted for effective child support services.