Get Saf Affidavit

The SAF Affidavit is an important document used to provide proof of payment when other forms of evidence, such as canceled checks or financial institution statements, are unavailable. This guide will walk you through the process of completing the affidavit online, ensuring clarity and accuracy in every step.

Follow the steps to complete the SAF Affidavit online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the name of the person who made the payment in the designated field. Ensure this name matches what appears on the check or other financial documents.
3. Next, provide the name of the eligible person. If this name differs from the first, include an explanation of the relationship in the given space.
4. Fill in the facility name where the services were rendered or the payment was made.
5. Enter the LUST number, which is associated with the relevant site or context regarding the affidavit.
6. In the subsequent section, confirm the invoices for which payment has been made. List the invoice numbers, corresponding dates, and amounts paid, ensuring accuracy in your entries.
7. After filling out all the necessary information, read the statement of accuracy. Sign and print your name, include the date, and add your title in the respective fields.
8. Provide the phone number of the service provider, along with the company's name and mailing address.
9. Lastly, ensure the affidavit is signed by a notary public and the commission expiration date, as well as the county and state, are included.
10. Review the completed affidavit for any errors before saving changes. You can then download, print, or share the final document as needed.

Complete your SAF Affidavit online today to ensure timely processing of your reimbursement requests.