Article Structure
Dos and Don'ts
When filling out the Maryland Domestic Partnership form, it is essential to follow certain guidelines to ensure accuracy and compliance. Here are ten things you should and shouldn't do:
- Do carefully read the entire form before starting to fill it out.
- Don't leave any required fields blank; all sections must be completed.
- Do ensure both partners meet the eligibility requirements outlined in the affidavit.
- Don't provide false information, as this can lead to serious legal consequences.
- Do gather all necessary documentation to support your claims of financial interdependence and shared residence.
- Don't submit the form without double-checking for errors or omissions.
- Do include your most recent income tax filing if your domestic partner qualifies as a tax dependent.
- Don't forget to sign and date the form; both partners must provide their signatures.
- Do keep copies of all documents submitted for your records.
- Don't attempt to file another affidavit until at least one year after the termination of the domestic partnership.
Misconceptions
Understanding the Maryland Domestic Partnership form can be challenging, and several misconceptions often arise. Here are four common misunderstandings:
- Misconception 1: Domestic partners must be legally married.
- Misconception 2: Any couple can register as domestic partners.
- Misconception 3: Financial interdependence is not necessary for a domestic partnership.
- Misconception 4: Domestic partners cannot include dependents in their health coverage.
This is false. The Maryland Domestic Partnership form is specifically designed for couples who are not legally married but wish to establish a recognized partnership. Couples can enjoy certain benefits without the legal status of marriage.
This is not entirely accurate. To qualify, couples must meet specific criteria, such as being at least 18 years old, not being related by blood or marriage within four degrees, and having been in a committed relationship for at least 12 consecutive months.
This is incorrect. The form requires evidence of financial interdependence. Couples must provide documentation, such as joint bank accounts or shared property, to demonstrate their commitment and support for one another.
This is misleading. The Maryland Domestic Partnership form allows for the inclusion of a domestic partner’s dependents in health coverage, provided certain criteria are met. This includes proof of the dependent’s relationship to the domestic partner and evidence of support.
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Key takeaways
Filling out and using the Maryland Domestic Partnership form can be a straightforward process, but it is essential to understand the requirements and implications involved. Here are some key takeaways to keep in mind:
- Eligibility Criteria: Both partners must be at least 18 years old, not related by blood or marriage within four degrees, and not currently married or in another partnership. This ensures that the partnership is recognized legally.
- Financial Interdependence: To demonstrate financial ties, provide documents such as joint ownership of property or shared bank accounts. This helps establish that you are supporting each other financially.
- Common Residence: You must share a primary residence. Evidence can include joint leases or utility bills that list both partners' names. This confirms that you live together as a couple.
- Tax Dependent Status: If your domestic partner qualifies as a tax dependent, certain benefits may be eligible for tax-favored treatment. Ensure you meet all criteria, including providing over half of their support.
- Affidavit Accuracy: It is crucial to provide accurate information on the affidavit. Falsifying details can lead to severe consequences, including legal action and loss of benefits. Always notify the relevant department of any changes in your relationship status.
Understanding these points can help you navigate the process more effectively. Remember, taking the time to fill out the form correctly can ensure that you and your domestic partner receive the benefits you are entitled to.
Guidelines on Utilizing Maryland Domestic Partnership
Completing the Maryland Domestic Partnership form involves several key steps to ensure that all necessary information is accurately provided. Once the form is filled out correctly, it will need to be submitted to the appropriate department for processing. Below are the steps to guide you through the completion of the form.
- Begin by filling in the names of both the Employee/Retiree and the Domestic Partner in the designated spaces at the top of the form.
- Confirm that both partners meet the eligibility requirements by checking off each condition listed in the Domestic Partnership section. These include age, relationship status, and duration of the committed relationship.
- Provide documentation to establish financial interdependence. Choose one of the options listed and attach the relevant document, such as a joint lease or a shared bank account statement.
- Indicate that you share a common primary residence. Again, provide one of the specified documents, such as a joint lease or utility bill that shows both names and the shared address.
- If applicable, complete the Tax Affidavit section. Initial each criterion that applies to your Domestic Partner, ensuring you include a copy of your most recent income tax filing with sensitive information blacked out.
- Sign and date the affidavit at the bottom of the form, ensuring both the Employee/Retiree and Domestic Partner provide their signatures and Social Security numbers.
- For any dependents of the Domestic Partner, fill out the Dependent Tax Affidavit section. Include the name, date of birth, and Social Security number of the dependent.
- Initial the appropriate boxes for the dependent’s relationship, marital status, and age/capability requirements, ensuring you attach the necessary documentation for each category.
- Complete the Tax Criteria section by initialing the appropriate boxes for either the Qualifying Child Test or the Qualifying Relative Test, based on the dependent’s situation.
- Finally, both the Employee/Retiree and the Domestic Partner must sign and date the form again to affirm that all information provided is true and accurate.
Form Preview Example
Affidavit for Domestic Partnership and Domestic Partner’s Dependents
This Affidavit must be completed if you are adding coverage for a Domestic Partner or Dependent Child of a Domestic Partner
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Domestic Partnership: |
I, _________________________________ and |
________________________________________, |
(Employee/Retiree) |
(Domestic Partner) |
certify that we are Domestic Partners (as defined in the benefits guide) and that we:
(1)Are each at least 18 years old;
(2)Are not related to each other by blood or marriage within four degrees of consanguinity under civil law rule;
(3)Are not married, in a civil union, or in a domestic partnership with another individual;
(4)Have been in a committed relationship of mutual interdependence for at least 12 consecutive months in which each individual contributes to some extent to the other individual’s maintenance and support with the intention of remaining in the relationship indefinitely;
Financial Interdependence is established by providing one of following dated documents:
(a)Joint ownership or lease of a motor vehicle
(b)Joint lease, mortgage or deed of your primary residence
(c)Joint checking, savings, investment, or credit account
(d)Designation as the primary beneficiary for life insurance, retirement benefits or the domestic partner’s will
(e)Mutual assignments of valid durable powers of attorney under Estates and Trusts Article,
(f)Mutual valid written advanced directives under
(5)Share our common primary residence.
Common Primary Residence is established by providing one of the following documents:
(a)Joint lease, mortgage or deed of your primary residence
(b)Copies of individuals’ driver’s license,
(c)Utility or other household bill with both the name of the insured and the domestic partner appearing.
Tax Affidavit for Domestic Partner:
In some cases, your Domestic Partner may qualify as an eligible tax dependent. If he/she meets all three criteria below, the coverage attributable to your domestic partner may be eligible for
Initials |
Tax Dependent Criteria: |
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The Dependent is a person who is not my lawful spouse who lives with me and is a member of my household |
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for the entire year. |
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I provide over half of the Dependent’s support for the calendar year(s) in which coverage is provided. |
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The Dependent is not my or anyone else’s qualifying child for the tax year(s) in which coverage is provided. |
We solemnly affirm under the penalties of perjury under applicable state laws, that the foregoing is true and accurate. We understand that willful falsification of information contained in this Affidavit can result in referral of the matter for investigation and prosecution, the termination of enrollment and coverage of the domestic partner, and the termination of coverage for the employee/retiree. We understand that a civil action may be brought against us for any losses, including reasonable attorney fees, because of a false statement contained in this affidavit. In addition, where permissible, employment related action may be taken against an active employee.
We agree to promptly notify the Department of Budget and Management, Employee Benefits Division upon any changes or circumstances attested to in this affidavit. We understand that we may not file another affidavit until at least one (1) year after termination of this domestic partnership.
_________________________________________ __________________________ |
_________________________ |
Signature of Employee/Retiree |
Social Security Number |
Date |
_____________________________________ ________________________ |
_________________________ |
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Signature of Domestic Partner |
Social Security Number |
Date |
Dependent Tax Affidavit for Domestic Partner’s Dependents:
Name of Employee/Retiree: ________________________________ Social Security Number: __________________________
Name of Domestic Partner’s Dependent: _____________________________________________________________________
Dependent’s Date of Birth: ______________________Social Security Number: ______________________________________
Part A: Dependent Relationship, Marital Status, and Age/Capability Requirements
A. Initial the box for the correct dependent relationship for your domestic partner’s dependent listed above. If none apply, this person is NOT eligible to be added to your health benefits coverage.
Initials |
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Dependent Relationship |
Required Documentation |
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Biological Child of Domestic Partner |
- Copy of Child’s Official State Birth Certificate |
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Adopted Child or child placed with domestic partner for adoption |
- Copy of Adoption papers indicating child’s date of birth |
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by the Domestic Partner |
- For pending adoptions – see Benefits Guide |
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- Copy of Child’s Official State Birth Certificate |
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- Copy of domestic partner’s Official State Marriage Certificate from |
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previous marriage |
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Grandchild of Domestic Partner |
- Copy of Child’s Official State Birth Certificate |
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- Copy of Child’s Parent’s Official State Birth Certificate (to show |
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relationship to domestic partner) |
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Legal Ward of Domestic Partner (permanently resides with my |
- Copy of Child’s Official State Birth Certificate |
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domestic partner and my domestic partner is his/her testamentary |
- Proof of Residency (Valid Driver’s License, or |
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or court appointed |
guardian for a |
Identification Card, school records or day care records certifying |
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not less than 12 months.) |
dependent’s address, Tax Documents listing child’s name certifying |
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address.) |
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- Copy of Legal Ward/Testamentary Court |
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Document, signed by a Judge. |
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Other Child Relative (includes |
- Copy of Child’s Official State Birth Certificate |
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Partner - dependent is related to my domestic partner by blood, |
- Proof of Residency (Valid Driver’s License, or |
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permanently resides with my domestic partner, and my domestic |
Identification Card, school records or day care records certifying |
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partner provides his/her sole support. |
dependent’s address, Tax Documents listing child’s name certifying |
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address.) |
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- Signature of Sole Support Affirmation (see below) |
B. Initial the box below, if the Dependent is NOT married. If this person is married, he/she is NOT eligible for State employee/retiree health benefits coverage.
The Dependent is NOT married
C. Initial the box by the statement that describes the Dependent. If neither statement accurately describes this Dependent, this person is not eligible for State employee/retiree health benefits coverage.
The Dependent is under the age of 25.
The Dependent is any age and is incapable of
Sole Support Affirmation for Other Child Relative Dependent ONLY:
I certify by my signature below that the dependent child listed on this form is supported solely by me and/or my domestic partner.
___________________________________________ |
_____________________ |
Domestic Partner’s Signature |
Date |
Part B: Tax Criteria:
In some cases, the dependent of your Domestic Partner may qualify as your eligible tax dependent. If he/she meets all four criteria for the Qualifying Child Test or all three criteria for the Qualifying Relative Test on the following page the coverage attributable to your domestic partner’s dependent may be eligible for
Initials |
Qualifying Child Test Criteria – must meet all four criteria |
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The child is my biological child or adopted child (or placed for adoption by me), my legal ward or child placed with me |
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under court order (not temporary for less then 12 months), sibling, or descendent of my child or sibling (i.e. grandchild, |
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niece, nephew, etc); and |
The child lives with me for more than half of the year (more than six months) or is my biological or adopted child and meets the following residence exceptions:
-The child received over half of the child’s support during the calendar year from the child’s parents, who (1) are divorced or legally separated under a decree of divorce or separate maintenance, or (2) are separated under a written separation agreement, or (3) live apart at all times during the last six months of the calendar year; and
-The child is in the custody of one or both of the child’s parents for more than half of the calendar year; and
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The Child (1) has not attained age 19 as of the close of the calendar year(s) in which coverage is provided, or (2) is a full- time student for at least five months of the calendar year who has not attained age 24 as of the end of the calendar year(s) in which coverage is provided, or (3) is permanently and totally disabled; and
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The child has not provided more than half of the child’s own support for the calendar year(s) in which coverage is provided. |
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Initials |
Qualifying Relative Test Criteria – must meet all three criteria |
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The Dependent has a specified relationship to me: my biological child, my adopted child (or placed for adoption by me), |
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my |
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me and is a member of my household for the entire year (this includes a legal ward); and |
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I provide over half of the Dependent's support for the calendar year(s) in which coverage is provided; and |
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The Dependent is not my or anyone else's qualifying child for the tax year(s) in which coverage is provided. If this child meets |
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criteria for the Qualifying Child Test, this statement is not true. |
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We solemnly affirm under the penalties of perjury under applicable state laws, that the foregoing is true and accurate.
We understand that willful falsification of information contained in this Affidavit will result in our termination of enrollment. We understand that a civil action may be brought against us for any losses, including reasonable attorney fees, because of a false statement contained in this affidavit.
_________________________________________ |
_________________________ |
Signature of Employee/Retiree |
Date |
_________________________________________ |
_________________________ |
Signature of Domestic Partner |
Date |
Rev 9/1/09 |
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Common mistakes
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Incomplete Information: Many individuals fail to provide all necessary information, such as the full names of both partners and their respective Social Security numbers. Omitting any required details can delay processing or result in rejection of the application.
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Incorrect Documentation: Submitting the wrong type of documentation to establish financial interdependence or common residence is a common mistake. It is essential to ensure that the documents meet the specific requirements outlined in the form.
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Failure to Meet Eligibility Criteria: Some applicants do not fully understand the eligibility criteria for a domestic partnership. For example, partners must not be married or in another domestic partnership. Failing to meet these criteria can lead to disqualification.
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Not Initialing Tax Affidavit Sections: The tax affidavit portion requires initials for specific criteria. Neglecting to initial these sections can result in the dependent being ineligible for tax-favored treatment.
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Ignoring Signature Requirements: Both partners must sign the affidavit. Forgetting to obtain the necessary signatures can render the application invalid, causing delays in coverage.
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Not Updating Changes: Individuals often overlook the requirement to notify the Department of Budget and Management about any changes in circumstances. Failing to do so can lead to penalties or termination of benefits.
Learn More on This Form
What is the Maryland Domestic Partnership form?
The Maryland Domestic Partnership form is an affidavit that allows individuals to certify their domestic partnership status for the purpose of obtaining health benefits. This form is necessary for employees or retirees who wish to add a domestic partner or dependent child of a domestic partner to their health coverage.
What are the eligibility requirements for a domestic partnership in Maryland?
To qualify as domestic partners under the Maryland Domestic Partnership form, both individuals must be at least 18 years old, not related by blood or marriage within four degrees, and not involved in another marriage, civil union, or domestic partnership. Additionally, they must have been in a committed relationship for at least 12 consecutive months and share a common primary residence.
What documents are needed to establish financial interdependence?
Financial interdependence can be demonstrated through various documents, such as a joint lease or mortgage, joint bank accounts, or mutual designations of beneficiaries for life insurance or retirement benefits. Other acceptable documents include mutual durable powers of attorney or advanced directives that name the domestic partner as a health care agent.
How can a domestic partner's dependent be added to health benefits coverage?
To add a dependent child of a domestic partner to health benefits, the individual must provide documentation proving the dependent's relationship, such as a birth certificate or adoption papers. The dependent must also meet certain criteria regarding age, marital status, and residency. If the dependent is not married and is either under 25 or incapable of self-support due to a disability, they may qualify for coverage.
What is the Tax Affidavit for Domestic Partner's Dependents?
This affidavit allows the employee or retiree to claim their domestic partner's dependent as an eligible tax dependent under certain conditions. The dependent must reside with the employee for the entire year, receive over half of their support from the employee, and not qualify as someone else's child for tax purposes.
What happens if false information is provided on the affidavit?
Providing false information on the Maryland Domestic Partnership form can lead to serious consequences, including termination of enrollment and coverage for the domestic partner, as well as potential civil action for losses incurred. Individuals may also face employment-related actions if applicable.
Can the affidavit be filed again after termination of a domestic partnership?
No, once a domestic partnership is terminated, individuals must wait at least one year before they can file another affidavit for a new domestic partnership. It is important to notify the Department of Budget and Management, Employee Benefits Division, of any changes regarding the domestic partnership status.