Required Verification Documents
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1 Required Verification Documents Dependent Category Documents Required to Complete Dependent Verification Option Tax Form Option 2 Legal Marriage Certificate Two Joint Financial Documents Legal Marriage (Opposite Sex or Same Sex) Marriages in 2015: Send the Legal Marriage Certificate only. Send a copy of your legal marriage certificate Send a copy of the first page of your 1040 federal income tax return showing a married filing status. If you file separately, send the first page of both your and your spouse s federal income tax return. Do not send W-2s. Send a copy of your legal marriage certificate Send copies of two current joint financial documents showing you and your spouse at the same address. Examples of joint financial documents include: mortgage statement, joint homeowners or renters insurance declaration page, auto insurance policy declaration page, auto loan, personal loan, credit card, and utility bill (except mobile phone bills). Documents must be dated within the past 60 days. Documents must be from two different organizations (for example, do not send a credit card statement and auto loan statement from the same bank). Legal Separation Agreement Legal Separation Send a COPY of your Legal Separation Agreement on file with the court. If a Legal Separation Agreement is not available, please submit the documents for Legal Marriage, along with a letter of explanation. Divorce Final Divorce Decree Send a COPY of your Final Divorce Decree on file with the court. Terminated Domestic Partnership Final Affidavit of Terminated Domestic Partnership Send a COPY of your Final Affidavit of Terminated Domestic Partnership. If this document is not available, please write a letter of explanation, or other documentation that verifies your relationship is terminated.
2 Dependent Category Documents Required to Complete Dependent Verification Option Tax Form Option 2 Declaration of Informal Marriage Certificate/ State Affidavit of Common Law Marriage Two Joint Financial Documents Common Law Marriage Send a copy of the first page of your 1040 federal income tax return showing a married filing status. If you file separately, send the first page of both your and your spouse s federal income tax return. Do not send W-2s. Send a copy of your Declaration of Informal Marriage Certificate or your State Affidavit of Common Law Marriage. Send copies of two current joint financial documents showing you and your spouse at the same address. Examples of joint financial documents include: mortgage statement, joint homeowners or renters insurance declaration page, auto insurance policy declaration page, auto loan, personal loan, credit card, and utility bill (except mobile phone bills). Documents must be dated within the past 60 days. Documents must be from two different organizations (for example, do not send a credit card statement and auto loan statement from the same bank). Affidavit of Same-Sex Domestic Partnership Two Joint Financial Documents Domestic Partnership Send a COPY of your Affidavit of Same-Sex Domestic Partnership on file with Wake Forest University (or a new affidavit, if you do not have the original). Send copies of two current joint financial documents showing you and your spouse at the same address. Examples of joint financial documents include: mortgage statement, joint homeowners or renters insurance declaration page, auto insurance policy declaration page, auto loan, personal loan, credit card, and utility bill (except mobile phone bills). Documents must be dated within the past 60 days. Documents must be from two different organizations (for example, do not send a credit card statement and auto loan statement from the same bank).
3 Dependent Category Black out any Social Security numbers, financial figures, or account numbers on documents you submit. Birth Certificate is required for each biological child 6 months old or older. The birth certificate must be issued by the state, county, or other government body list the employee as a parent. Short form birth certificates, which only list the name and date of birth of the child, will not be accepted. Biological Child Hospital Letter If birth certificate is not available for a child under 6 months old, submit birth documentation on hospital letterhead indicating the birth date of the child or children, the names of the parent(s). Court Order If birth certificate is not available, a court order (such as a Qualified Medical Child Support Order, National Medical Support Notice or other court document) may be substituted. Adopted Child Placement Papers Adoption Agreement Birth Certificate Send a copy of the placement papers for a child placed with you for adoption (initial stage), or Official Court Adoption Agreement for an adopted child (mid-stage), or legal birth certificate (final stage). Court Order If birth certificate is not available, a court order (such as a Qualified Medical Child Support Order, National Medical Support Notice or other court document) may be substituted. Child s Birth Certificate Send a copy of the child s government-issued birth certificate showing that the child s parent is the employee s spouse. Stepchild Legal Marriage or Common Law Marriage Documents See notes in the Legal Marriage or Common Law Marriage sections for information about submitting these documents. Child s Birth Certificate Send a copy of the child s government-issued birth certificate showing that the child s parent is the employee s spouse. Child of a Domestic Partnership Domestic Partner Documents See notes in the Domestic Partner section for information about submitting these documents. Foster Child Placement Papers Send a copy of the placement papers from the agency or government office. The placement papers must name the faculty or staff member as a foster parent. Other Child Type For a grandchild, niece/nephew, brother/sister, or other child type, send guardianship papers. Guardianship Papers Court papers demonstrating legal guardianship. Document must include the name(s) of the person(s) designated as the legal guardian(s).
4 Key to Document Status on Website Banner Displayed by Dependent s Name What Banner Means You must submit verification documents for this dependent. Click on Click Here for Documents to read the specific document requirements for this dependent. This dependent is not eligible to continue coverage. Refer to the reason given for more explanation. The documents submitted for this dependent are not complete, or something is missing. Please scroll down to the Comments section to read a message from the auditor to see what is missing. You can also call to speak with an auditor regarding the incomplete submission. This dependent has been verified, and the dependent eligibility process requirements have been met. No further action is required for this dependent.
5 Document Submission Form TO: Dependent Eligibility Center Fax Number: Faculty or Staff Member s Name: Call-Back Phone Number: Total Pages Sent: Contents Documents Submitted Document 1 Document 2 Document 3 Document 4 Document 5 Document 6 Document 7 Document 8 Important Notices Save your document submission, including your fax confirmation sheet, in a safe place until you log back into your audit website or call to verify that your dependents are complete. You will receive a call regarding your document submission ONLY if anything is missing or incomplete. Log back in to your verification website 3 business days after faxing or ing your documents (7 business days if mailed) to check your status. When a dependent is complete and eligible, you will see a green COMPLETE banner. If a dependent shows any other banner, please review the notes and/or contact us at for more information.
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