Get Dos Ds-5111 2021-2025

The DoS DS-5111 form, also known as the Certification of Foster Child Status, is essential for ensuring that your foster child receives coverage under the Federal Employees Health Benefits Program. This guide provides clear instructions on how to effectively fill out this form online, ensuring a smooth submission process.

Follow the steps to complete the DoS DS-5111 online.

1. Press the ‘Get Form’ button to obtain the DoS DS-5111 form and open it in the editor.
2. In Section 1, provide the foster child's information. Fill in the child's date of birth using the format mm-dd-yyyy, followed by entering the child's full name, which includes last, first, and middle names.
3. Proceed to Section 2, the Employee Verification Statement. Begin by stating that you have enclosed a government-issued birth certificate or another document verifying the foster child's date of birth.
4. List the proof of regular and substantial support for the foster child. You may include any of the following: evidence of eligibility for benefits under other programs, proof of inclusion in your income tax returns, canceled checks, money orders, or receipts for payments made for the child, or other evidence deemed sufficient.
5. In the employee's information section, fill out your full name, Social Security Number, email address, and phone number.
6. Provide your signature and date (mm-dd-yyyy) at the bottom of the form. Ensure all details are accurate and complete.
7. Once you have filled out the form, review it for any errors and make necessary corrections. You can then save changes, download the completed document, print it, or share it as needed.

Start completing the DoS DS-5111 online today.