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Printable Form 13615 Jersey City New Jersey: What You Should Know
Do not use the form for self-service distribution. If you know that your partner does not have a website, please contact them directly to verify whether certification is available. 18 July 2023 — VITA/THE's application to The Urban Institute for Children and Families is still closed. A Certificate of Certification that is acceptable for use by the City of NJ and its agencies shall consist of the following: a. A full, verified application indicating completion of all requirements, including but not limited to a written Declaration of Eligibility under penalty of perjury stating that the applicant met all the requirements of the certification application process and an original proof of address which was issued to the applicant with an address in the City of New Jersey. b. A copy of a current and valid birth certificate issued by an appropriate governmental authority, if such authority issued an original certificate. c. A copy of a court order confirming full compliance with the legal requirements of the certification application process, if there was a court order for the certificate to be issued. d. A copy of a valid Social Security account number in order for VITA/THE to collect benefits (if applicable); a copy of a valid insurance plan in which to pay benefits (if applicable); and a statement from the applicant indicating he or she understands all the documentation requirements of the certification application process and that he or she understands that once the certification application has been concluded by submitting materials and payment requirements, then any child or children named on the form will no longer be eligible for the following benefits: a. The Federal Public Benefits (public assistance and Medicare) and federal health care programs including, but not limited to, the following programs: Title 1: Medicare (Old Age, Survivors, and Disability Insurance) Title 2: Medical Assistance Title 3: Medical Care for Children Title 8: Education Benefits for Children and Youth (Foster Care) Title 9: Youth Support and Development Grants Title 13: Child Care and Development Funds Title 13: Disability Insurance Title 21: Supplemental Security Income Title 33: Income Security. Title 34: Supplemental Security Income. Title 50: Welfare and Food Stamps Title 59: Unemployment Insurance for Survivors. Title 59: Temporary Assistance for Needy Families for Mothers and Children without Dependent Spouses.
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