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 Doh 4255 2011-2024

Ny Statement Certification 2011-2024 Form

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Video instructions and help with filling out and completing DOH 4255 Form

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In our demo today we'll be going through an application for a family a single mom Josephine and her son Marvin both of them are looking to pay for hEvalth care coverage at this point in our scenario Josephine has created an account and has been identity proof in account holders I did our identity proofs so that the marketplace can protect a consumers personal information and privacy on this first page of the application we enter in basic information about the family we ask consumers to include themselves their spouse any children they are taken care of and anyone they will include on their federal tax return Josephine's information was pre-populated from the account creation process to enter in information about Marvin when filling out the application it's important to click on the blue box at the top of the screen if you want the marketplace to see if you qualify for federal financial assistance on the first set of screens we asked for demographic information about each person on the

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