Get Selfcertification Of Nonu - Va

Filling out the Self-Certification Of Non-U - VA form online is an essential step for veterans seeking extended care services. This guide will provide clear, step-by-step instructions to ensure users can successfully complete the form with confidence.

Follow the steps to fill out the Self-Certification Of Non-U - VA online.

1. Click ‘Get Form’ button to acquire the Self-Certification Of Non-U - VA form and open it for editing.
2. Begin with Section I. Input your name and full social security number accurately to establish your identity.
3. Move to Section II. Provide insurance information. Indicate whether you are enrolled in Medicare and detail any other health insurance coverage, including the name and contact details of your insurance company.
4. Proceed to Section III. Here, you must document information about your spouse and dependents. Indicate their names, social security numbers, and current residency status.
5. In Section IV, report on fixed assets. This includes your primary residence and any additional owned property, minus any debts. Be sure to follow the instructions on which assets need to be reported.
6. Section V requires you to list any liquid assets, such as bank accounts, stocks, or collectibles. Remember to exclude the primary residence and personal items.
7. Continue to Section VI. Here, document the gross income of both you and your spouse, including various income sources, and ensure to clarify the frequency of each source.
8. In Section VII, outline all deductible expenses incurred by you, your spouse, or dependents. This includes educational costs, medical expenses, and any other relevant financial obligations.
9. After filling out the necessary sections, review Sections VIII and IX, where you need to consent to copayment agreements and sign to authorize submission.
10. Finally, submit your application by organizing all required supporting documentation and returning the original form to the appropriate VA facility. You can then save changes, download, print, or share the completed form as needed.

Complete your Self-Certification Of Non-U - VA form online today for access to extended care services.