Get Dhhs 004 Form

Filling out the Dhhs 004 Form, also known as the Identifying Information Form, is a vital step for parents and volunteers in child care settings. This guide will provide you with clear, step-by-step instructions to navigate the process with ease.

Follow the steps to complete the form accurately and efficiently.

1. Click 'Get Form' button to access the Dhhs 004 Form and open it in the editor.
2. Begin by filling in the individual's maiden name and any previous names used in the designated lines. Ensure this information is complete.
3. In the section for the individual's name, fill in the ovals for the last name first, making sure it matches the names on any other forms submitted. If the name exceeds the available space, write the full name at the top of the form.
4. Indicate the individual's social security number by filling in the corresponding ovals clearly.
5. Fill in the ovals for the individual's date of birth, ensuring the year is entered as four digits.
6. Specify the individual's gender in the designated area.
7. Indicate the individual's race using the appropriate options provided.
8. Provide a current active contact telephone number for the individual, ensuring its accuracy.
9. Complete the home mailing address section by filling in the ovals. If using a Post Office Box, include the physical address in the extra space provided on the form.
10. Name the county of residence accurately, ensuring it matches the address provided in the previous step.
11. Fill in the ovals for the individual’s active email address.
12. Select the 'Uncompensated provider' (volunteer) job type as applicable.
13. Finally, sign the form with your first and last name (in blue or black ink) and date it, ensuring it corresponds to the information listed in step one.
14. Once you have filled out all sections, review the form for completeness and clarity before saving changes, downloading, printing, or sharing the document as necessary.

Complete your Dhhs 004 Form online today for a smoother process!