Form dhr fia 1130-2025

1. Click ‘Get Form’ to open the dhr fia 1130 in the editor.
2. Begin by filling in the Local Department and Date fields at the top of the form. This information is essential for processing your request.
3. In the Case Name and Address sections, provide accurate details about your case. Ensure that you include your CID# for reference.
4. Move on to Section I, where you will check off items under BASIC REQUIREMENTS. Indicate whether you have or need each document listed.
5. Proceed to Section II for DEMOGRAPHIC DATA. Fill in necessary proofs such as Social Security Number and Medicare Card details, marking them as N/A, OK, or NEED.
6. Continue with Section III for INCOME VERIFICATION. Provide income-related documents and specify if they are needed or already available.
7. In Section IV, list all ASSETS including bank accounts and life insurance details. Make sure to indicate which documents are required.
8. Finally, review all sections for completeness before submitting your form through our platform.

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