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Get Ia 470-5143 2013-2025
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How to fill out the IA 470-5143 online
The IA 470-5143 form is essential for users seeking to authorize the Iowa Department of Human Services to conduct various background checks. This guide provides clear, step-by-step instructions on how to effectively complete this form online.
Follow the steps to fill out the IA 470-5143 with ease
- Press the ‘Get Form’ button to access the document and open it in the appropriate online editor.
- Begin by providing your last name, first name, and middle name in the designated fields. Ensure that your information is accurate and legible.
- If you have any aliases, enter them in the alias fields provided. You can include multiple aliases if necessary.
- Input your date of birth, followed by your gender. This information is critical for the background check process.
- Fill in your social security number in the specified format. This detail is necessary for identity verification.
- Complete your address by including Address 1, Address 2 (if applicable), city, state, and zip code. Accurate address details assist in processing your request.
- If applicable, provide your maiden name in the designated field. This information may be relevant for background checks.
- Review all the entered information for accuracy and completeness before proceeding.
- After verifying the details, you can save your changes, download the filled form, print it, or share it as required.
Complete your IA 470-5143 form online now for a smooth authorization process.
1-800-338-7752 (Toll Free) Services Offered: Medicaid eligibility verification tool using automated voice response.
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