PFD Forms

State of Alaska

PFD 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 at Adobes' website:

Additional Absence Form

Address Change Form

Adult Certification Form

Adult Estate Application

Adult Information Change/Addition Form

Adult Prior Year Non-Filer

Adult Supplemental Schedule (Division Requested)

Audit Form

Child Certification Form

Child Estate Application

Child Information Change/Addition Form

Child Prior Year Non-Filer

Direct Deposit Form (Add Change or Withdraw)

Disabled Application

Dividend Assignment of Rights

Education Verification Form

Note: National Student Clearinghouse verifications do not suffice for the PFD verification because they do not provide tuition information required by PFD

Extended Absence Questionnaire

Licensed Health Care Provider's Certification of Disability

Medical Treatment Verification

Physician's Statement for Terminally Ill Care

Request to Withdraw Application

Request to Withdraw Competing Application

Sponsor Eligibility Form

UA College Savings Plan Add or Withdrawal

Verifiers Designation

Working Out of State Questionnaire

If you are having problems viewing forms or need forms for a prior year contact the division.

Disclaimer: Information posted on this website summarizes the Permanent Fund Dividend Program, is supplemental only, and does not supersede the applicable Statutes and Regulations.