Get Declaration Format In Word

Filling out the Declaration Format in Word online is a straightforward process that ensures accurate submission of your information. This guide will provide step-by-step instructions on completing the form to meet your needs effectively.

Follow the steps to complete the Declaration Format in Word.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor. This action will allow you to access the Declaration Format quickly.
2. Begin with the Patient Information section. Enter the patient’s name in the designated field, followed by their date of birth in the next section. Ensure that the address and phone number are filled in accurately, as this information is critical for contact purposes.
3. Navigate to the Declaration of Employment section. State your principal employment by filling in the blank with your occupation. Indicate your employment status by selecting either 'I am working' or 'I am not working' accordingly. Provide the employer's name and the address for the relevant details.
4. In the Declaration of Income and Family Size section, document your household income for the previous year in the appropriate field. Enter your monthly family income in the next section. Additionally, provide the total number of people living in your household, including all family members.
5. Review the certification statement ensuring the accuracy of the information provided. Acknowledge your understanding of the use of this information regarding eligibility for the Sliding Scale Discount.
6. Sign and date the form in the designated areas. This step confirms your approval of the information and your awareness of the requirements concerning documentation submission.
7. Once all fields have been accurately completed, you can save your changes. At this point, you have the option to download, print, or share the form as necessary.

Complete your Declaration Format online today to ensure timely processing of your application.