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State of Georgia Department of Community AffairsDUPLICATION OF BENEFITS CERTIFICATIONThe undersigned, on behalf of and as a duly authorized agent and representative of___ (Applicant), certifies and
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How to fill out duplication of benefits certification

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How to fill out duplication of benefits certification

01
Obtain the duplication of benefits certification form from your insurance provider or relevant agency.
02
Fill out your personal information such as name, address, and contact details.
03
Provide details of your current insurance coverage including policy number and coverage limits.
04
Specify any additional benefits you are receiving from other sources such as FEMA or private organizations.
05
Sign and date the form to certify the accuracy of the information provided.
06
Submit the completed duplication of benefits certification form to the appropriate authority for review.

Who needs duplication of benefits certification?

01
Individuals who have been affected by a disaster and are receiving benefits from multiple sources such as insurance companies, FEMA, or private organizations.

What is DUPLICATION OF BENEFITS CERTIFICATION Form?

The DUPLICATION OF BENEFITS CERTIFICATION is a document required to be submitted to the required address in order to provide certain info. It must be completed and signed, which may be done manually, or via a certain solution e. g. PDFfiller. This tool lets you complete any PDF or Word document right in the web, customize it depending on your purposes and put a legally-binding electronic signature. Right after completion, you can send the DUPLICATION OF BENEFITS CERTIFICATION to the appropriate receiver, or multiple individuals via email or fax. The blank is printable too because of PDFfiller feature and options offered for printing out adjustment. Both in digital and physical appearance, your form will have got clean and professional look. You can also save it as the template for further use, without creating a new file again. All you need to do is to customize the ready sample.

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Duplication of benefits certification is a process used to ensure that federal disaster assistance does not exceed the amount of the loss experienced by an individual or entity, essentially confirming that they are not receiving funds from multiple sources for the same loss.
Individuals and entities that have received federal disaster assistance and have also received other forms of assistance for the same disaster-related expenses are typically required to file this certification.
The duplication of benefits certification is filled out by providing detailed information about the assistance received, including sources of funding and amounts, as well as documentation that verifies the incurred losses and expenses.
The purpose of the duplication of benefits certification is to prevent the misuse of federal disaster assistance funds and to ensure that individuals are not compensated more than their actual loss.
Information that must be reported includes the types and amounts of assistance received, the specific losses incurred, and any other forms of compensation that relate to the same disaster.
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