The Absent Parent form is used by MassHealth applicants in Massachusetts when a child's parent is absent from the household, has an unknown identity, or has died. Its full name is the Absent-Parent Questions and Assignment of Rights form.
Part A of the form requires applicants to cooperate with the Child Support Enforcement Division of the Massachusetts Department of Revenue to establish paternity and enforce medical support orders. Applicants may claim "Good Cause" if they have a legally supported reason for not cooperating. You do not need to cooperate if you are applying for health benefits for the child only, not for yourself.
The form must be signed under penalty of perjury, confirming that all information is accurate and complete. Applicants may also request child-support-enforcement services independently from the MassHealth application process.
| Question | Answer |
|---|---|
| Form Name | Absent Parent Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | mass health absent parent form, non custodial parent form ncp 1, parent non custodial form for masshealth, absent patent no custodial parent |