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Completion of the non custodial parent form ncp 1

Completion of the non custodial parent form ncp 1 2026

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The document is a Noncustodial Parent Form from MassHealth, intended for custodial parents or legal guardians applying for state health plans in Massachusetts. It requires information about noncustodial parents of children listed in the application to assist in collecting medical support. The form outlines the responsibilities of the custodial parent, including cooperation with MassHealth and the Child Support Enforcement Division, and details exceptions where certain information may not be required. It emphasizes that while benefits will not be denied for non-cooperation, eligibility may be affected.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the name of Child #1. Fill in the first, middle, and last names as required.
Indicate if any special circumstances apply to Child #1 by checking the appropriate boxes provided.
Next, provide information about the noncustodial parent for Child #1. Include their first name, middle name, last name, relationship to the child, gender, date of birth, and any other relevant details.
Repeat steps 2-4 for Child #2 and Child #3 as necessary. Ensure all applicable fields are filled out accurately.
Finally, review all entered information for accuracy before signing at the end of the form. Your signature certifies that you are the custodial parent or legal guardian.

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