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EMPLOYEE BENEFITS DIVISION
New York State Health Insurance Program (SHIP)
Domestic Partner Enrollment ApplicationPS425 (10/19)PLEASE READ PAGES 47 BEFORE YOU COMPLETE AND SUBMIT THIS APPLICATION.
EMPLOYEE
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How to fill out domestic partner enrollment application
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01
Obtain the domestic partner enrollment application from the appropriate source.
02
Read the instructions carefully to understand the requirements and eligibility criteria.
03
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04
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11
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12
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Who needs domestic partner enrollment application?
01
Anyone who wishes to enroll their domestic partner in a specific program, such as employee benefits or insurance, may need to fill out a domestic partner enrollment application. The exact eligibility requirements and purposes may vary based on the program and the organization offering it.
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What is domestic partner enrollment application?
Domestic partner enrollment application is a form that allows individuals to register their domestic partnership with the appropriate authorities.
Who is required to file domestic partner enrollment application?
Any individuals who wish to establish a legal domestic partnership must file a domestic partner enrollment application.
How to fill out domestic partner enrollment application?
Domestic partner enrollment application can typically be filled out online or submitted in person at the designated office. It requires basic information about the partners and their relationship.
What is the purpose of domestic partner enrollment application?
The purpose of domestic partner enrollment application is to legally recognize and provide benefits to couples in a domestic partnership.
What information must be reported on domestic partner enrollment application?
Information such as names, addresses, dates of birth, and declaration of domestic partnership are typically required on the domestic partner enrollment application.
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