Form dma 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin with Section 1, where you will provide your personal information. Fill in the date, your name, and address accurately.
3. In Section 2, list family members and tax dependents living in your household. For each person, indicate if they expect to file a tax return and whether they are pregnant or have Medicaid.
4. Proceed to Section 3 to provide additional details about income and living situations for those listed. If applicable, complete Attachment B for income details.
5. Finally, sign the form in Section 4 under penalty of perjury, confirming that all information is true to the best of your knowledge.

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