[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-150581-en":3,"doc-seo-150581-105":29,"detail-sidebar-cat-0-en-105":90},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":20,"is_downloadable":20,"audit_status":20,"page_count":20,"language":21,"language_code":22,"site_id":23,"html_lang":22,"table_of_contents":24,"faqs":25,"seo_title":26,"seo_description":14,"update_tm":27,"read_time":28},150581,2336475104362,"Mali","https://ap-avatar.wpscdn.com/avatar/22000c4c46a41b752dd?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786595829695023868",7,"Healthcare","DDS-355 - Paupers Affidavit","DDS-355 Paupers Affidavit is a waiver form used to request relief from reinstatement fees for suspended drivers who certify they cannot pay based on answers provided in the form. It specifies ineligible suspension types and requires parent or legal guardian completion for minors. The form collects suspended driver identity details, household information, qualifying benefit options, address and household composition, custody status if applicable, and signature with date. It includes a definition of household and a warning about false statements.","This form is used to waive reinstatement fees for drivers who certify that they are unable to pay their reinstatement fees based on an evaluation of responses provided on this form.  \nIneligible suspensions are: Super Speeder, Nonsufficient Funds and Safety Responsibility.  \n*Minors with a suspension must have this form completed by a parent or legal guardian.  \n\n| Suspended Driver’s Information\u003Cbr>Name:  \u003Cbr>Last Name First Name MI\u003Cbr>GA Driver License, Permit, or Identification Card \\#:   Date of Birth:  / /  \u003Cbr>MM DD YYYY\u003Cbr>Head of Household (HOH):  |\n| --- |\n| **Household Information\u003Cbr>**If you are seventeen (17) years of age or younger your parent or legal guardian will need to complete this section.\u003Cbr>I,   , certify as follows:\u003Cbr>Enter your Full Name Above\u003Cbr>  I am eighteen (18) years of age or older.–OR–\u003Cbr>Initial\u003Cbr>  I am the parent or legal guardian of the suspended driver, who is under the age of eighteen (18) years.\u003Cbr>Initial |\n| 1. That I, by reason of poverty, am unable to pay the entire fee required by O\u003Cbr>2. That I am providing proof that I qualify for one or more of the benefits listed\u003Cbr>☐ Supplemental Nutrition Assistance Program (SNAP)\u003Cbr>☐ Temporary Assistance Nutrition Funding (TANF)\u003Cbr>☐ Women, Infants and Children (WIC)\u003Cbr>3. That I live at  \u003Cbr>Street \\# Street Name\u003Cbr>4. That my household consists of   people.\u003Cbr>\\# in Home\u003Cbr>–OR–\u003Cbr>  That I am in the custody of\u003Cbr>Agency Name\u003Cbr>.\u003Cbr>below:\u003Cbr>C.G.A §40-5-9 to reinstate my driving privilege.\u003Cbr>☐ Medicaid\u003Cbr>☐ Free or Reduced Lunch Program ☐ Detention Certification Documentation\u003Cbr>Apt \\# City State Zip Code |\n| Signature of Suspended Driver –OR– Suspended Driver’s Parent or Legal Guardian\u003Cbr>This   day of   20   \u003Cbr>Day Month Year Signature of Suspended Driver–OR-Suspended Driver’s Parent or Legal Guardian |\n\n**A household consists of one or more people who live in the same dwelling and share meals or living accommodation.  \nWARNING: Any person knowingly making any false statement on this affidavit commits the offense of false swearing and shall be guilty of a felony.","cbCaih8UnsTe7N8P","https://ap.wps.com/l/cbCaih8UnsTe7N8P","pdf",160039,1,"English","en",105,"# Suspended Driver Information\n## Household and eligibility certification\n## Benefits, address, and household composition\n## Signature and legal warning","[{\"question\":\"Who can use the DDS-355 Paupers Affidavit to waive reinstatement fees?\",\"answer\":\"Drivers who certify they are unable to pay reinstatement fees based on the form’s evaluation of their provided responses may use it. Minors must have the form completed by a parent or legal guardian.\"},{\"question\":\"Which suspensions are not eligible for this fee waiver?\",\"answer\":\"The form lists ineligible suspensions as Super Speeder, Nonsufficient Funds, and Safety Responsibility.\"},{\"question\":\"What qualifying benefits can be checked on the form?\",\"answer\":\"The form provides checkboxes for Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance Nutrition Funding (TANF), and Women, Infants and Children (WIC), along with other listed options.\"}]","DDS-355 - Paupers Affidavit | PDF",1787822867,3,{"code":4,"msg":30,"data":31},"ok",{"site_id":23,"language":22,"slug":32,"title":13,"keywords":33,"description":14,"schema_data":34,"social_meta":85,"head_meta":87,"extra_data":89,"updated_unix":27},"dds-355-paupers-affidavit","",{"@graph":35,"@context":84},[36,52,67],{"@type":37,"itemListElement":38},"BreadcrumbList",[39,43,47,49],{"item":40,"name":41,"@type":42,"position":20},"https://docshare.wps.com","Home","ListItem",{"item":44,"name":45,"@type":42,"position":46},"https://docshare.wps.com/document/","Document",2,{"item":48,"name":12,"@type":42,"position":28},"https://docshare.wps.com/document/healthcare/",{"item":50,"name":13,"@type":42,"position":51},"https://docshare.wps.com/document/dds-355-paupers-affidavit/150581/",4,{"url":50,"name":13,"@type":53,"author":54,"headline":13,"publisher":56,"fileFormat":59,"inLanguage":22,"description":14,"dateModified":60,"datePublished":61,"encodingFormat":59,"isAccessibleForFree":62,"interactionStatistic":63},"DigitalDocument",{"name":9,"@type":55},"Person",{"url":40,"name":57,"@type":58},"DocShare","Organization","application/pdf","2026-09-04","2026-08-27",true,{"@type":64,"interactionType":65,"userInteractionCount":20},"InteractionCounter",{"@type":66},"ViewAction",{"@type":68,"mainEntity":69},"FAQPage",[70,76,80],{"name":71,"@type":72,"acceptedAnswer":73},"Who can use the DDS-355 Paupers Affidavit to waive reinstatement fees?","Question",{"text":74,"@type":75},"Drivers who certify they are unable to pay reinstatement fees based on the form’s evaluation of their provided responses may use it. Minors must have the form completed by a parent or legal guardian.","Answer",{"name":77,"@type":72,"acceptedAnswer":78},"Which suspensions are not eligible for this fee waiver?",{"text":79,"@type":75},"The form lists ineligible suspensions as Super Speeder, Nonsufficient Funds, and Safety Responsibility.",{"name":81,"@type":72,"acceptedAnswer":82},"What qualifying benefits can be checked on the form?",{"text":83,"@type":75},"The form provides checkboxes for Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance Nutrition Funding (TANF), and Women, Infants and Children (WIC), along with other listed options.","https://schema.org",{"og:url":50,"og:type":86,"og:title":13,"og:site_name":57,"og:description":14},"article",{"robots":88,"canonical":50},"index,follow",{"doc_id":7,"site_id":23},{"code":4,"msg":5,"data":91},[92,96,100,104,109,114,117,122,127,130,134],{"id":20,"doc_module":4,"doc_module_name":45,"category_name":93,"show_sort_weight":94,"slug":95},"Story & Novel",90,"story-novel",{"id":46,"doc_module":4,"doc_module_name":45,"category_name":97,"show_sort_weight":98,"slug":99},"Literature",80,"literature",{"id":51,"doc_module":4,"doc_module_name":45,"category_name":101,"show_sort_weight":102,"slug":103},"Exam",70,"exam",{"id":105,"doc_module":4,"doc_module_name":45,"category_name":106,"show_sort_weight":107,"slug":108},5,"Comic",60,"comic",{"id":110,"doc_module":4,"doc_module_name":45,"category_name":111,"show_sort_weight":112,"slug":113},6,"Technology",50,"technology",{"id":11,"doc_module":4,"doc_module_name":45,"category_name":12,"show_sort_weight":115,"slug":116},40,"healthcare",{"id":118,"doc_module":4,"doc_module_name":45,"category_name":119,"show_sort_weight":120,"slug":121},8,"Research & Report",30,"research-report",{"id":123,"doc_module":4,"doc_module_name":45,"category_name":124,"show_sort_weight":125,"slug":126},9,"Religion & Spirituality",20,"religion-spirituality",{"id":125,"doc_module":4,"doc_module_name":45,"category_name":128,"show_sort_weight":125,"slug":129},"World Cup","world-cup",{"id":131,"doc_module":4,"doc_module_name":45,"category_name":132,"show_sort_weight":131,"slug":133},10,"Lifestyle","lifestyle",{"id":135,"doc_module":4,"doc_module_name":45,"category_name":136,"show_sort_weight":105,"slug":137},19,"General","general"]