Get the up-to-date doh 5090-2025 now

Show details

4.7 out of 5

29 votes

The Attestation of Identity Form is required by NY State of Health for applicants who cannot provide necessary documentation to verify their identity. The form allows individuals to attest to their identity under penalty of perjury, enabling the processing of their health coverage applications. It outlines acceptable documents for verification and provides instructions for submission, including contact information for assistance.

Here's how it works

01. Edit your doh 5090 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 doh 5090 form via email, link, or fax. You can also download it, export it or print it out.

The fastest way to redact Doh 5090 online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Dochub is a perfect editor for updating your paperwork online. Adhere to this straightforward guideline edit Doh 5090 in PDF format online free of charge:

Register and log in. Register for a free account, set a strong password, and proceed with email verification to start working on your forms.
Upload a document. Click on New Document and choose the form importing option: upload Doh 5090 from your device, the cloud, or a secure link.
Make changes to the template. Utilize the upper and left panel tools to edit Doh 5090. Add and customize text, images, and fillable areas, whiteout unnecessary details, highlight the significant ones, and comment on your updates.
Get your documentation completed. Send the sample to other people via email, create a link for faster file sharing, export the template to the cloud, or save it on your device in the current version or with Audit Trail added.

Explore all the advantages of our editor today!

See more doh 5090 versions

We've got more versions of the doh 5090 form. Select the right doh 5090 version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2013	4.7 Satisfied (29 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is proof of income for NY State of Health?

The proof must be dated within 6 months of when you signed the application. PROOF OF CURRENT INCOME, OR INCOME YOU MIGHT GET IN THE FUTURE LIKE UNEMPLOYMENT BENEFITS OR A LAWSUIT: You must provide a letter, written statement, or copy of check or stubs, from the employer, person or agency providing the income.

What is proof of address for NY State of Health?

Examples of proof include; paystub(s) with address, lease covering the date of application, signed letter from a landlord, rent receipt or mortgage statement, tax 2 Page 3 statements/bills, current bill or other statement, school letter, report card, postmarked envelope, drivers license with current address, magazine,

What is proof of address verification?

Proof of address is a document that confirms your residential address. Common examples include utility bills, bank statements, and government correspondence. To be accepted, the document must be issued by a recognised authority, contain your full name and residential address, and be dated within the last three months.

What is proof of address in NY?

If you are applying for a REAL ID or Enhanced document you must provide two proofs of New York State residency. A New York State license, permit or non-driver id card, a recent bank statement, or a recent pay stub showing your current New York State address are just some of the acceptable proofs of residency.