Get Dr 4679

The Dr 4679 form serves as an affidavit for restrictions on public benefits, requiring users to declare their citizenship or lawful presence in the United States. This guide will provide you with clear, step-by-step instructions to successfully complete the form online.

Follow the steps to complete the Dr 4679 online efficiently.

1. Begin by clicking the ‘Get Form’ button to access the Dr 4679 form and open it in your document editor.
2. In the primary applicant section, enter your full name as it appears on your identification.
3. Select one of the three options to indicate your citizenship status: either being a United States citizen, a permanent resident, or lawfully present in the United States.
4. If applicable, provide your Alien Registration Number in the designated space.
5. If you are married, fill out the spouse section with their full name and follow the same citizenship declaration process.
6. Both the primary applicant and spouse (if applicable) should read the statement regarding the implications of false representation and provide signatures along with the respective dates.
7. In the proof of identification section, select one type of identification you will be providing and ensure that your selected form meets the verification requirements.
8. If you are unable to provide the required identification, consider requesting a waiver through the Colorado Department of Revenue.
9. Once all sections are completed, review the information for accuracy. You can then save your changes, download the form, print it, or share it as needed.

Complete your Dr 4679 online today to fulfill your application requirements.