How to use or fill out the stimulus application form with our platform
- Click ‘Get Form’ to open the stimulus application form in the editor.
- Begin by filling out the 'Personal Information' section. Enter your previous employer group name, last name, first name, social security number, date of birth, address, city, state, zip code, and phone number.
- Next, review the eligibility criteria. You must check 'YES' for all statements regarding your employment loss and COBRA coverage. Ensure you understand each statement before proceeding.
- If applicable, complete the 'Dependent Information' section for each dependent. Provide their name, date of birth, relationship to you, and social security number or other identifier.
- Finally, sign and date the form at the bottom. Make sure to print your name and indicate your relationship to the employee.
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See more stimulus application form versions
We've got more versions of the stimulus application form form. Select the right stimulus application form version from the list and start editing it straight away!
| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2009 | 4.6 Satisfied (40 Votes) |
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