Golden Buckeye Card Application - Ohio Resident
This file is an application for the Golden Buckeye Card, aimed at Ohio residents aged 60 or older or those with disabilities. It includes instructions for filling out the application and submitting it for a card replacement. The card offers various benefits and discounts for eligible seniors in Ohio.
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How do I fill this out?
To fill out the Golden Buckeye Card application, start by entering your personal information clearly. Be sure to provide accurate information, especially regarding your eligibility. Once completed, follow the instructions for submission.
How to fill out the Golden Buckeye Card Application - Ohio Resident?
1
Read the eligibility criteria carefully.
2
Fill in your personal details, including your name and address.
3
Provide your date of birth and contact information.
4
Sign the application electronically or manually.
5
Submit the application via email, fax, or mail.
Who needs the Golden Buckeye Card Application - Ohio Resident?
1
Seniors aged 60 and above applying for the Golden Buckeye Card.
2
Residents between 18-59 with a Social Security-defined disability.
3
Healthcare or social service representatives assisting eligible individuals.
4
Family members helping seniors apply for benefits.
5
Community organizations supporting outreach and application processes.
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What are the instructions for submitting this form?
To submit the Golden Buckeye Card application, you can email it to GoldenBuckeyeApps@age.ohio.gov, fax it to 1-877-767-9954, or mail it to the Golden Buckeye Program at 30 E Broad St / 22nd Floor, Columbus, OH 43215-3414. Make sure all required fields are filled out completely and accurately before submission to avoid delays in processing. Keep copies of your submitted application for your records.
What are the important dates for this form in 2024 and 2025?
Applications for the Golden Buckeye Card can be submitted at any time. Keep an eye on any announcements regarding enrollment deadlines or changes to the program in 2024 and 2025.
What is the purpose of this form?
The purpose of this form is to provide a means for eligible individuals to apply for the Golden Buckeye Card, which offers numerous benefits and discounts throughout Ohio. It specifically caters to seniors and those living with disabilities, ensuring they can access various resources and support services. By gathering necessary information, the form plays a crucial role in determining applicants' eligibility for the program.
Tell me about this form and its components and fields line-by-line.
- 1. First Name: Applicant's first name.
- 2. Last Name: Applicant's last name.
- 3. Mailing Address: Full address including house number and street.
- 4. Date of Birth: Applicant's date of birth in mm/dd/yyyy format.
- 5. Email Address: Contact email for communication.
- 6. Signature: Declaration of truthfulness and consent.
- 7. Phone Number: Contact phone number including area code.
- 8. Disability Documentation: Options for documenting disability as proof.
What happens if I fail to submit this form?
Failing to submit the Golden Buckeye Card application may lead to missed opportunities for benefits and discounts. Without the card, eligible individuals might not access essential services specifically designed to support seniors and those with disabilities.
- Benefit Denial: Without submission, eligible applicants will not receive the benefits associated with the Golden Buckeye Card.
- Lost Time: Delays in applying could mean missing out on current offers and discounts.
- Increased Difficulty: Individuals may find it harder to access services without the card.
How do I know when to use this form?
- 1. New Card Application: Use this form if you have never received a Golden Buckeye Card before.
- 2. Replacement Card Request: Use this if your existing Golden Buckeye Card has been lost or damaged.
- 3. Disability Verification: Residents aged 18-59 applying based on disability need to make use of this form.
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