How to use or fill out OMB No. 0938-1191 with our platform
- Click ‘Get Form’ to open the OMB No. 0938-1191 application in the editor.
- Begin by filling out Step 1, which requires personal information. Enter your first name, middle name, last name, and suffix. Provide your home address, city, state, ZIP code, and county.
- Continue with your contact details including phone numbers and email preferences. Indicate if you need health coverage for yourself and provide your Social Security number and date of birth.
- Move to Step 2 to include additional individuals needing health coverage. Repeat the process for each person by entering their names, relationships, Social Security numbers, and other relevant details.
- In Step 3, indicate if anyone in your family is American Indian or Alaska Native. If yes, provide their names and tribe information.
- Complete the application by signing in Step 4 under penalty of perjury. Ensure all information is accurate before submitting.
- Finally, mail your completed application to the specified address provided in Step 5.
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