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Domestic partnership certificate

Domestic partnership certification 2026

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The document is a Domestic Partnership Dependent Certification Form used by employees of a company to declare their domestic partner as a dependent for federal income tax purposes. It outlines the process for certifying or rescinding this status, including the responsibilities of the employee to notify the benefits department if their dependency status changes. The form requires signatures from both the employee and a benefits representative.

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Click ‘Get Form’ to open the Domestic Partnership Certification in the editor.
Begin by entering your name in the designated field, confirming your identity as the employee claiming the domestic partner.
In the next section, provide your domestic partner's name, ensuring accuracy for tax purposes.
Indicate the effective tax year for which you are claiming your domestic partner as a dependent by filling in the appropriate field.
Review and check the statement that applies to your situation regarding dependency status.
Sign and date the form at the bottom, including your Social Security Number for verification.
Finally, forward the completed form to your benefits representative for processing.

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