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2828 Casey Alma Way Winter Park, FL 32792 Phone: (407) 9371031 Fax (877)2945798 www.ENTSinusOrlando.com CONSENT FORM AUTHORIZATION I certify that I (or my dependent) has insurance coverage as listed
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To fill out 'I certify that I', follow these points:
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Start by typing or printing your full name in the space provided.
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Next, indicate the date when you are signing the certification.
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Read the statement carefully and make sure you understand it fully.
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If you agree with the statement and are willing to certify the information, affix your signature in the designated area.
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Review the completed form once again to ensure accuracy and completeness.
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Finally, submit the form to the relevant authority or keep a copy for your records.

Who needs i certify that i?

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The 'I certify that I' statement is typically required in various official or legal documents. This can include employment applications, financial forms, government applications, legal contracts, and many others. Basically, anyone who is required to provide a sworn statement or declaration may need to fill out 'I certify that I'.
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