This job aid shows benefits officers how to print and optionally edit dependent verification forms for employees:

• Print the Affidavit of Parent-Child Relationship Form
• Print the Domestic Partner Dependent Certification Form
• Edit the Affidavit of Parent-Child Relationship Form
• Edit the Domestic Partner Dependent Certification Form

Note: Benefits Officers can print the Affidavit of Parent Child Relationship form and the Domestic Partner Dependent Certification form only if the employee has first completed either form in eBenefits Self Service via a self service life event transaction, self service new hire enrollment or self service Open Enrollment event. Benefits Officers cannot generate nor edit nor populate (fill out) a 'blank' Affidavit of Parent Child Relationship form and the Domestic Partner Dependent Certification form in CHRS.

You cannot generate a Affidavit of Parent Child Relationship form or the Domestic Partner Dependent Certification form for the dependent re-verification process via CHRS at this time.

Step 1: Open the CSU Benefits Administrator tile.

Step 2: Navigate to Update Dependent/Beneficiary.

• Employee/Dependent Information > Update Dependent/Beneficiary

Step 3: Search for the employee.

• The employee Update Dependent/Beneficiary page opens.

Step 4: Open the CSU Dependent tab.

Step 5: Use the arrow buttons to select the record for the Recognized Child.

• In this example, the recognized child’s name is literally “Recognized Child.” You will need to know the actual name of the recognized child to do this task.

Step 6: From the Action Taken menu, select Print Affidavit of PCR form.

Step 7: Click Go!

• The completed form opens in another browser tab.

Step 8: Click the Printer icon to print the form to PDF or to send to a paper printer.,

Step 9: Close the browser tab when you are finished.

Use this procedure to print the form. If you need to update the form first, complete the optional step.

Step 1: Open the CSU Benefits Administrator tile.

Step 2: Navigate to Update Dependent/Beneficiary.

• Employee/Dependent Information > Update Dependent/Beneficiary

Step 3: Search for the employee.

• The employee Update Dependent/Beneficiary page opens.

Step 4: Open the CSU Dependent tab.

Step 5: Use the arrow buttons to select the record for the Domestic Partner.

• In this example, the domestic partner’s name is literally “Domestiq Partner.” You will need to know the actual name of the domestic partner to do this task.

Step 6: From the Action Taken menu, select Print Domestic Partner Cert.

Step 7: Click Go!

• The completed form opens in another browser tab.

Step 8: Click the Printer icon to print the form to PDF or to send to a paper printer.

Step 9: Close the browser tab when you are finished.

Step 1: Open the CSU Benefits Administrator tile.

Step 2: Navigate to Update Dependent/Beneficiary.

• Employee/Dependent Information > Update Dependent/Beneficiary

Step 3: Search for the employee.

• The employee Update Dependent/Beneficiary page opens.

Step 4: Open the CSU Dependent tab.

Step 5: Use the arrow buttons to select the record for the Recognized Child.

• In this example, the recognized child’s name is literally “Recognized Child.” You will need to know the actual name of the recognized child to do this task.

Step 6: From the Action Taken menu, select Edit Affidavit of PCR form.

Step 7: Click Go!

• The form opens in another browser tab.

Step 8: Edit the fields on the form as necessary:

• Date of primary parental status
• Relationship to PCR Dependent
• First Name
• MI
• Last Name
• SSN
• Date of Birth
• Address1
• Address 2
• City
• State
• Zip Code

Step 9: Click Save.

Use this procedure to print the form. If you need to update the form first, complete the optional step

Step 1: Open the CSU Benefits Administrator tile.

Step 2: Navigate to Update Dependent/Beneficiary.

• Employee/Dependent Information > Update Dependent/Beneficiary

Step 3: Search for the employee.

• The employee Update Dependent/Beneficiary page opens.

Step 4: Open the CSU Dependent tab.

Step 5: Use the arrow buttons to select the record for the Domestic Partner.

• In this example, the domestic partner’s name is literally “Domestiq Partner.” You will need to know the actual name of the domestic partner to do this task.

Step 6: Update the form:

1. Insert a new Effective Dated Row.
2. Confirm the Effective Date.
3. Update the fields.

• If the Domestic Partner Dependent’s tax status changes, the employee fills out a paper DPDC form, submits it to the campus Benefits Office, and the campus Benefits Office staff updates Domestic Partner Dependent Certification form.
  • Tax Dependent: Check this box only if the domestic partner is a Tax Dependent for the applicable tax year.
  • Tax Year: Enter the tax year
  • Certificate on File: Indicates supporting documentation was received.
  • Certified By (Officer): This field is not required but can be used by Benefits Office staff to enter their name.

Step 7: From the Action Taken menu, select Edit Domestic Partner Cert.

Step 8: Edit the form as appropriate.

• Claim domestic partner for tax purposes OR
• Cancel Domestic partner for tax purposes
• Select Tax year

Step 8: Click Save.

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