Form Hhs 92 PDF Details

The Form Hhs 92 is a declaration of intention form used to declare your intent to become a resident of a foreign country. This form is not required for all countries, so please check with the embassy or consulate of the country you are interested in before submitting this form. There may be other requirements that must be met before you can become a resident of that country, so please be sure to research all the necessary steps prior to filing this form. The Form Hhs 92 must be completed in its entirety and submitted along with all supporting documentation in order to be considered by the appropriate authorities. Thank you for your interest in becoming a resident of (foreign country).

QuestionAnswer
Form NameForm Hhs 92
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namespayable, PHOTOCOPY, LEGIBLY, DHHS

Form Preview Example

APPLICATION FOR CERTIFIED COPY OF DEATH CERTIFICATE

This office has been registering deaths occurring in Nebraska since 1904.

PLEASE TYPE OR PRINT LEGIBLY

Full name of deceased ________________________________________________________________________________

(If female, list married name or any other name(s) decedent may have used)

City or town of death _______________________________________ County of death _____________________________

(If exact place of death is not known, list last known address)

Month, day and year of death ___________________________________________________________________________

(If exact date of death is unknown, list date decedent was last known to be alive or indicate a span of years to search)

How are you related to decedent?________________________________________________________________________

For what purpose is this record to be used? ________________________________________________________________

___________________________________________________________________________________________________

The information in this section is needed in order to do a thorough search in locating and identifying the requested record:

Year of birth _____________________________________________ Birthplace __________________________________

Spouse’s full name ________________________________________ Home address ______________________________

Father’s full name _____________________________________________________________________________________

Mother’s full name _____________________________________________________________________________________

Funeral Director __________________________________________ City _______________________________________

WARNING: Section 71-649, Nebraska Revised Statutes: It is a felony to obtain, possess, use, sell, furnish, or attempt to obtain any vital record for purposes of deception.

PLEASE ENCLOSE A PHOTOCOPY OF YOUR PHOTO ID (i.e., DRIVER’S LICENSE) WHEN MAILING IN THIS REQUEST.

SIGNATURE _____________________________________________

Type or print name ________________________________________

Mailing Address __________________________________________

City, State, Zip ___________________________________________

Daytime Telephone Number _________________________________

Email Address ___________________________________________

Fees are subject to change without notice. Please call our 24-hour recorded message at (402) 471-2871 to verify fees.

Number of certified copies________ x $16.00 each = $________ Total

(Please make checks payable to Vital Records)

Mail to:

Bring to:

Vital Records

Vital Records

PO Box 95065

1033 O Street, Suite 130

Lincoln, NE 68509-5065

Lincoln, NE 68508-3621

(Please enclose a stamped, self-addressed business size envelope.)

FOR OFFICE USE ONLY

 

q Check q MO

q Cash

Amount Received ________________________

Date Received __________________________

By Whom Received ______________________

PROOF OF IDENTIFICATION;

DLSTATE IDOTHER

______________________________________

HHS-92 (55092) Rev. 5/14

How to Edit Form Hhs 92 Online for Free

payable can be filled in easily. Simply open FormsPal PDF editor to complete the task fast. We at FormsPal are focused on giving you the absolute best experience with our tool by continuously introducing new features and enhancements. Our tool has become much more useful thanks to the most recent updates! So now, filling out documents is easier and faster than ever. To get the ball rolling, consider these easy steps:

Step 1: Just hit the "Get Form Button" in the top section of this site to launch our pdf editor. This way, you'll find all that is necessary to fill out your file.

Step 2: Using this state-of-the-art PDF editor, you may accomplish more than just fill in blank form fields. Edit away and make your documents appear high-quality with customized text added in, or optimize the file's original input to excellence - all that supported by an ability to add stunning pictures and sign the PDF off.

With regards to the blanks of this specific document, this is what you need to know:

1. While completing the payable, make sure to complete all important fields within its associated form section. It will help to expedite the process, allowing your information to be processed promptly and accurately.

How one can fill in 1904 portion 1

2. After the previous section is filled out, go on to type in the suitable details in all these: Mothers full name, Funeral Director City, WARNING Section Nebraska Revised, PLEASE ENCLOSE A PHOTOCOPY OF YOUR, FOR OFFICE USE ONLY, q Check q MO q Cash, SIGNATURE, Amount Received, Type or print name, Date Received, Mailing Address, By Whom Received, City State Zip, Daytime Telephone Number, and PROOF OF IDENTIFICATION.

The best way to fill out 1904 portion 2

People often make mistakes while completing FOR OFFICE USE ONLY in this section. Ensure you read again whatever you type in here.

3. This next segment is typically quite simple, Number of certified copies x each, Mail to Bring to Vital Records, Please enclose a stamped, and HHS Rev - all of these form fields needs to be completed here.

Please enclose a stamped, HHS Rev, and Number of certified copies x each in 1904

Step 3: Confirm that the details are correct and then press "Done" to conclude the task. Obtain the payable once you sign up for a 7-day free trial. Instantly access the document in your personal cabinet, along with any modifications and changes all synced! FormsPal guarantees risk-free form editor without personal data recording or distributing. Rest assured that your details are in good hands with us!

Form Hhs 92 isn’t the one you’re looking for?

Related Documents