Get Attendant Affidavit - Co Howard In

Completing the ATTENDANT AFFIDAVIT - Co Howard In is essential for documenting the care provided to a claimant. This guide will assist you in filling out the form online accurately and efficiently.

Follow the steps to successfully complete the affidavit.

1. Click 'Get Form' button to access the affidavit form and open it in your preferred digital editor.
2. In the space provided, enter the veteran's name, ensuring you include the last name, first name, and middle name to maintain clarity.
3. Input the VA claim or social security number in the designated field, which is critical for identifying the claim.
4. Next, provide the claimant's name clearly, followed by their complete address, including the street, city, state, and zip code.
5. In the section regarding your name, write your full name, confirming that you are the individual providing care for the claimant.
6. Indicate the types of assistance you provide by checking 'Yes' or 'No' next to each service listed, such as bathing, walking, or medication management.
7. Fill in the compensation amount you receive from the claimant, selecting whether it is per day, week, month, or year by circling the appropriate option.
8. Record the date you began your employment in the space provided to give a timeline of care.
9. Sign and date the document in the specified area as the provider of care.
10. Enter your street address, city, state, and zip code, along with your phone number including the area code for contact purposes.
11. Certify the accuracy of the information provided by signing in the designated area and recording the date of signing.
12. If the claimant signs via a mark, ensure that two witnesses sign and date the form in the appropriate sections.
13. Once completed, review the document for any errors. You can then save changes, download, print, or share the affidavit as needed.

Complete the ATTENDANT AFFIDAVIT - Co Howard In online today to ensure proper documentation of care.