Get Highmark 3660-b 2019-2025

The Highmark 3660-B is an affidavit of domestic partnership that serves as a declaration of cohabitation and shared financial responsibilities. This guide will provide you with straightforward, step-by-step instructions to complete the form effectively and accurately.

Follow the steps to complete the Highmark 3660-B affidavit online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the state where you reside in the designated section at the top of the form.
3. Fill in the county where you and your partner reside, as required.
4. Both individuals must affirm they are at least eighteen years old and mentally competent. Indicate your affirmation by checking the appropriate box.
5. If either partner has previously been married, provide evidence of the marriage termination in the required field.
6. Confirm that you and your partner are not related by blood in a manner prohibited under New York law by checking the relevant box.
7. State that you have been living together on a continuous basis prior to the affidavit date, and check the box provided.
8. Verify that one of you is enrolled in an employer group health insurance program by checking the respective box.
9. Affirm that neither partner has been registered in another domestic partnership in the past six months by checking the box.
10. The enrollee must affirm their responsibility to file a Termination of Domestic Partnership form if the qualifying criteria change, marking this with a checkbox.
11. Both partners must print their names in the supplied fields.
12. Enter the street addresses for both the enrollee and the partner in their respective fields.
13. Fill in the city, state, and zip code for both individuals.
14. Provide signatures for both partners at the designated areas.
15. Find the notary section and complete it after signing, ensuring all information is accurate.
16. Submit proof of cohabitation and financial interdependence as required, checking the proofs submitted as applicable.
17. Save any changes made to the form, and download, print, or share the completed affidavit as needed.

Start filling out your Highmark 3660-B affidavit online today to finalize your domestic partnership.