Affidavit of residency massachusetts 2026

1. Click ‘Get Form’ to open the affidavit of residency Massachusetts in our editor.
2. Begin by entering the applicant’s full legal name in the designated field. Ensure that this matches your official identification.
3. If applicable, provide the applicant’s Social Security Number and Date of Birth in the respective fields.
4. Fill in the applicant’s member ID if you have one, followed by your current street address, phone number, and email address.
5. In the certification section, clearly state your residence details and the date you began living at this address. This is crucial for proving residency.
6. Sign and date the document where indicated. This confirms that all information provided is accurate and truthful.
7. Finally, choose to either fax or mail your completed affidavit to the Health Insurance Processing Center as instructed.

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