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How to use or fill out DHS 1125 instructions with our platform
- Click ‘Get Form’ to open the DHS 1125 in the editor.
- Begin by entering the Name of the Injured Beneficiary. Ensure you include the first name, middle initial, and last name accurately.
- Next, indicate the Date of Accident or Incident by filling in the month, day, and year when the event occurred.
- In the section labeled 'Dated:', specify the city and state where you are signing the form.
- Complete 'This ____day' by writing in the day when you sign this document.
- Fill in 'Of _____, ___' with the month and year of your signature.
- Provide your Signature as a Witness. This is self-explanatory but must be done carefully.
- The next field requires the Signature of Adult Beneficiary, Guardian, or Representative. Make sure it is signed by an authorized individual.
- Indicate your Printed Name as a Witness by entering your first name, middle initial, and last name.
- Fill in your Street Address where you reside.
- Lastly, indicate your Title or Relationship to the injured beneficiary for clarity on your connection.
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See more dhs 1125 instructions versions
| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2013 | 4.8 Satisfied (86 Votes) |
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