Follow the steps to successfully complete your enrollment request

1. Press the ‘Get Form’ button to access the form and open it in your editor.
2. Begin by entering your name in the designated field as the member, including your last name, first name, and middle initial. Next, provide your social security number.
3. In the next section, enter your common law spouse’s name, formatted as: last name, first name, and middle initial, along with their social security number.
4. Respond to the questions regarding your marital relationship. Indicate whether you are presented and known throughout your community as being in a marital relationship and if you are currently living in that relationship.
5. If applicable, specify the date on which you entered into your common law marriage and the state where you resided on that date.
6. Answer whether you and your partner have joint property or if you have filed a federal income tax return indicating a marital status, and provide the required documentation as proof.
7. Indicate if you have joint checking or savings accounts and include a copy of the last statement as required.
8. Declare if there are any factors preventing you from marrying and provide any additional explanations.
9. List the names and birth dates of any children born to you and your spouse, if applicable, and confirm if coverage for them is requested as eligible dependents.
10. Certify that all provided information is true and sign the form. Ensure that your signature is notarized, including the date.
11. Additionally, if you are having someone else complete the verification section, they must provide their details and notarized signature.
12. After completing all fields, save your changes, and choose to download, print, or share the form as needed.

Complete your forms online and ensure your enrollment is processed without delay.