Gems factual dependency form download 2025

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  1. Click ‘Get Form’ to open the gems factual dependency form in the editor.
  2. In Section A, provide your employee information including your last name, first name, date of birth, ID number, gender, mailing address, and contact details.
  3. Move to Section B and fill in the child's information. Include their last name, first name, date of birth, residential address, relationship to you, ID number, and the date you assumed responsibility for them.
  4. Carefully read Section C regarding dependent eligibility. Ensure that the child meets one of the specified criteria before proceeding.
  5. In Section D, sign and date the form. Remember to have it notarized and make a copy for your records before submitting it to your agency or university payroll office.

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