Page 25 - 2022 DPR Construction Benefit Guide_Craft Employees

Dependent Verification

Documentation

VALID DEPENDENT RELATIONSHIP DOCUMENTATION

If you would like to add dependents to your benefits – DPR does request proof of dependent relationship. Please provide the dependent
documentation with your enrollment form at time of enrollment. Eligible dependents include- spouse, domestic partner, child(ren) up until
age 26, disabled children have no age restrictions.

Dependent verification documentation options listed below.

Dependent Type Dependent Type
Copy of marriage certificate
Spouse A signed copy of page one and two of your 1040 tax return (you may cross out wage information and

social security numbers) must show you filed as married (head of household is unacceptable)
Domestic Partner Domestic Partner Affidavit

Copy of birth certificate*
Court Order (must show full dependent name)

Child Under Age 26* Adoption papers

A signed copy of page one and two of your 1040 tax return (you may cross out wage information and
social security numbers) must show you filed as married (head of household is unacceptable)

Copy of birth certificate*

Court Order (must show full dependent name)

Adoption papers
A signed copy of page one and two of your 1040 tax return (you may cross out wage information and
Child Over Age 26 social security numbers) must show you filed as married (head of household is unacceptable)

AND
Proof of disability from the Social Security Administration

Certified physician note stating that your child is not able to be self-supporting because of mental or
physical disability and depends mainly (more than 50% of income) on you for support

Copy of birth certificate naming your current, legally married spouse as the parent

OR

A signed copy of page one and two of your 2020 or 2021 1040 tax return (you may cross out wage
Stepchild information and social security numbers)
(Under Age 26) • Page two must be signed and can be substituted by a confirmation page if you filed your taxes

electronically
OR

Copy of court-issued Qualified Medical Child Support Order

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