VA DSS 032-05-0160-09 2017-2026 free printable template
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DEPARTMENT OF SOCIAL SERVICES (Model Form)Page 1 of 2SWORN STATEMENT OR AFFIRMATION FOR CHILD DAY PROGRAMS Please Print Name Current Mailing Address Name of Licensed/Registered Approved Facility/ProviderFirstMiddleMaidenStreet,
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Obtain the VA DSS 032-05-0160-09 form from the official website or designated office.
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Begin by filling out your personal information at the top of the form, including your name, address, and contact details.
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Follow the form's instructions to provide the required information in each section accurately.
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If applicable, include information about your financial situation as requested in the corresponding sections.
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Review the form to ensure all information is complete and accurate before submitting.
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Sign and date the form as required.
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Submit the completed form to the designated VA office, either in person or by mail, according to the provided guidelines.
Who needs VA DSS 032-05-0160-09?
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Individuals applying for VA benefits or services may need to fill out VA DSS 032-05-0160-09.
02
Veterans seeking assistance or verification of eligibility for state or federal programs may also require this form.
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Family members or dependents of veterans looking for benefits may need to complete this form as part of their application process.
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How do you write a sworn statement?
How to Write a Sworn Statement The name, age, occupation, and address of the declarant. A detailed account of the incident or events being recited. An endorsement paragraph stating that the sworn statement is true and subject to a penalty of perjury. The signature of the declarant. The date on which the document was created.
What is a sworn statement of affirmation in Virginia?
A sworn disclosure or affirmation is a statement completed by a person attesting to whether he has ever been: (i) convicted of or the subject of pending charges of any crime within the Commonwealth or equivalent offense outside the Commonwealth, or (ii) the subject of a founded complaint of child abuse or neglect
What is the meaning of sworn statement?
: a statement that someone makes under oath and swears to be true.
What is an example of a sworn statement?
I declare that, to the best of my knowledge and belief, the information herein is true and complete. I understand this statement is made for use as evidence in court and is subject to penalty for perjury.
What is a sworn declaration form?
A sworn declaration (also called a sworn statement or a statement under penalty of perjury) is a document that recites facts pertinent to a legal proceeding. It is very similar to an affidavit but is not witnessed and sealed by an official such as a notary public.
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What is VA DSS 032-05-0160-09?
VA DSS 032-05-0160-09 is a specific form used within the Virginia Department of Social Services for reporting and documenting certain information related to social service programs.
Who is required to file VA DSS 032-05-0160-09?
Individuals or entities that are involved in social service programs administered by the Virginia Department of Social Services may be required to file this form.
How to fill out VA DSS 032-05-0160-09?
To fill out VA DSS 032-05-0160-09, complete all required sections by providing accurate and detailed information as instructed on the form. Ensure to follow any specific guidelines provided by the Virginia Department of Social Services.
What is the purpose of VA DSS 032-05-0160-09?
The purpose of VA DSS 032-05-0160-09 is to collect necessary information for the assessment and management of social service programs in Virginia.
What information must be reported on VA DSS 032-05-0160-09?
The information that must be reported on VA DSS 032-05-0160-09 includes personal details of the individual or entity filing, relevant program data, and any other information as specified on the form and in the guidelines.
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