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Header: Department of Revenue - Permanent Fund Dividend Division
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Header: Forms
State of Alaska> Departments> Revenue> PFD Division > Forms

If you are having any trouble viewing these forms, you must have the Adobe Acrobat Reader 7.0. If you do not, you can get it here:

Absence Reporting
Additional Absence Notification Form

Address Change

Use only after you have submitted a 2006 dividend application
Address Change Form

Assignment of Rights

Assignment of Rights Form and Instructions

Certifications
Adult Certification
Child Certification

Direct Deposit

Use the form below only after you have submitted a 2006 dividend application

Direct Deposit Form

 

Education Verification

National Student Clearinghouse verifications do not suffice for the PFD verification because they do not provide tuition information required by PFD.
Education Verification Form
Eligibility
Adult Eligibility Form 54
Adult Eligibility Form 87
Eligibility Verification Form 74

Information Request

Adult Information Request
Child Information Request

Internet Signature

Adult Internet Signature Page

Child Internet Signature Page

 

Medical Treatment Verification

Medical Treatment Verification

Name Change

Adult Name or SSN Change Form
Child Name or SSN Change Form

Prior Year Non-Filer

Adult Prior Year Non-Filer
Child Prior Year Non-Filer

Request to Withdraw Competing Application

Competing Application Withdrawl Form

Supplemental Schedule

Supplemental Schedule

SSN Change

Adult Name or SSN Change Form
Child Name or SSN Change Form

UA College Savings 

Adult UA Savings Withdrawal
Child UA Savings Withdrawal

Withdraw an Application

Request to Withdraw an Application Form
Verifiers Designation
Verifiers Designation Form

If you have any trouble with these forms or need a form from a prior year, please contact your nearest  Dividend Information Office

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