Get Sshe Student Certification Form.doc

Completing the SSHE Student Certification Form.doc online is essential for ensuring health care coverage for your dependent student. This guide provides you with clear, step-by-step instructions to help you navigate the form efficiently.

Follow the steps to fill out the SSHE Student Certification Form online.

1. Click the ‘Get Form’ button to obtain the student certification form and open it in your preferred online editor.
2. Begin by filling out the employee or annuitant information section. Provide your name, personnel number, date of birth, address, and daytime telephone number.
3. Next, proceed to the dependent child information section. Enter the dependent student's name and date of birth, and specify their relationship to you by selecting the appropriate checkbox.
4. Indicate whether the student resides with you when not attending classes full-time by selecting 'Yes' or 'No'.
5. Complete the dependent student's marital status by selecting 'Single', 'Married', or 'Divorced'.
6. State whether the dependent is employed during the school year and detail their employment status as full-time or part-time if applicable.
7. Provide information about the current semester the student is attending, including the semester start date, name of the school, type of school, expected graduation date, and type of student (full-time or part-time). Include the number of credit hours for the semester.
8. Read and acknowledge the certification statement regarding the dependent's qualifications and any potential changes in their status impacting coverage.
9. Sign and date the form to confirm the information provided is accurate.
10. Finally, attach the required enrollment verification document as specified, either from the National Student Clearinghouse or a letter from the registrar.
11. Once completed, save your changes, then download, print, or share the form as needed before returning it to the university human resources office.

Complete your SSHE Student Certification Form online today to ensure your dependent student has the necessary health care coverage.