Hbd 40 2010 form-2026

See details

4.3 out of 5

46 votes

The document is an Affidavit of Parent-Child Relationship under California Code of Regulations section 599.500(o), which allows employees and annuitants to enroll children in a CalPERS-sponsored health plan if they have assumed a parental role. It outlines the requirements for establishing this relationship, including responsibilities such as providing care and support for the child, and mandates annual certification of the relationship until the child turns 26. The affidavit must be signed by the employee or annuitant, certifying the truthfulness of the information provided.

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out hbd 40 2010 form with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the hbd 40 2010 form in the editor.
Begin by filling out the Employee/Annuitant Information section. Enter your name, Social Security Number, and the date you assumed primary custodial parental role for the child.
Next, provide your relationship to the child and complete the Child Information section with the child's name, date of birth, and Social Security Number. If their address differs from yours, include that as well.
Indicate whether you have enrolled other children under CCR section 599.500(o) by selecting 'Yes' or 'No' and specify how many if applicable.
Proceed to certify your parent-child relationship by answering each eligibility question with 'Yes' or 'No', providing initials where required.
Finally, review all information for accuracy before signing and dating the document at the bottom.

Start using our platform today to easily fill out your hbd 40 2010 form for free!