Yes! You can use AI to fill out Form GEN 853, Declaration

Form GEN 853 is a legal document used by county agencies for individuals to provide a sworn statement of facts. By signing, the declarant affirms under penalty of perjury that the information provided is true and correct, giving the statement significant legal weight in official proceedings. Today, this form can be filled out quickly and accurately using AI-powered services like Instafill.ai, which can also convert non-fillable PDF versions into interactive fillable forms.
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Form specifications

Form name: Form GEN 853, Declaration
Number of pages: 1
Filled form examples: Form GEN 853 Examples
Language: English
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How to Fill Out GEN 853 Online for Free in 2026

Are you looking to fill out a GEN 853 form online quickly and accurately? Instafill.ai offers the #1 AI-powered PDF filling software of 2026, allowing you to complete your GEN 853 form in just 37 seconds or less.
Follow these steps to fill out your GEN 853 form online using Instafill.ai:
  1. 1 Navigate to Instafill.ai and upload or select the GEN 853 form.
  2. 2 Use the AI assistant to automatically populate your personal details, such as your full name, address, and contact information.
  3. 3 Enter the relevant case information, including the case name, case number, worker name, and customer ID.
  4. 4 Carefully type or dictate your statement into the main declaration text box, ensuring all information is true and correct.
  5. 5 Review all the information you've provided on the form for accuracy and completeness.
  6. 6 Electronically sign and date the form in the designated signature fields to certify your declaration under penalty of perjury.
  7. 7 Download, print, or securely submit your completed GEN 853 form as instructed by the county agency.

Our AI-powered system ensures each field is filled out correctly, reducing errors and saving you time.

Why Choose Instafill.ai for Your Fillable GEN 853 Form?

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Complete your GEN 853 in as little as 37 seconds.

Up-to-Date

Always use the latest 2026 GEN 853 form version.

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Accuracy

Our AI performs 10 compliance checks to ensure your form is error-free.

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Frequently Asked Questions About Form GEN 853

The GEN 853 form is a general declaration used to provide a sworn statement of facts related to your county case. You use it to declare that the information you provide is true and correct to the best of your knowledge, under penalty of perjury.

This form is typically completed by a client or customer involved in a county case who needs to provide a formal statement. Your caseworker will instruct you to fill it out when a sworn statement is required for your case file.

You will need your case name, case number, and customer ID, as well as your personal contact information. You should also be prepared to write the specific statement or declaration you need to make in the large text box.

This information should be provided to you by your caseworker or the county agency handling your case. It is often included in official letters or documents you have received from them.

In this section, you must write the specific facts or information you are attesting to for your case. Be clear, concise, and truthful, as you will be signing the form under penalty of perjury.

This means you can either sign your name or, if you are unable to sign, make a mark such as an 'X'. If you use a mark, it may need to be witnessed, so check with your caseworker for specific instructions.

The form includes a second signature line for situations where a co-applicant or another relevant party also needs to attest to the declaration. If you are the only person making the statement, you only need to sign on one line.

Submission instructions are typically provided by the county agency or your caseworker who requested the form. You will likely need to mail it or deliver it in person to the office handling your case.

If you are filling out this form as part of a new application, you may not have a case number or ID yet. In this situation, you can leave those fields blank or ask your caseworker for guidance on how to proceed.

This instruction means you must use this specific version of the form (GEN 853, 10/2020) for your declaration. The county will not accept your statement if it is submitted on a different or altered form.

Yes, services like Instafill.ai use AI to accurately auto-fill form fields like your name and address, which can save you time and help prevent errors. However, the personal declaration statement must be your own truthful account.

Simply upload the GEN 853 form to the Instafill.ai platform. The AI will identify the fields, allowing you to fill them in online, save your progress, and download the completed document.

If you have a non-fillable or 'flat' PDF, you can upload it to a service like Instafill.ai. It will automatically convert the document into an interactive, fillable form that you can complete on your computer.

Compliance GEN 853
Validation Checks by Instafill.ai

1
Required Case Identifier Presence
This check ensures that the 'Case Number' and 'Customer ID' fields are not empty. These numbers are critical for uniquely identifying the case and the individual within the system, and their absence would make it impossible to file or retrieve the document correctly. A failure would prevent form submission and prompt the user to enter the required identifiers.
2
Date Field Format Validation
Verifies that all date fields, including 'Date', '1st Signature Date Signed', and '2nd Signature Date Signed', are entered in a valid and consistent format (e.g., MM/DD/YYYY). This is crucial for maintaining accurate records and establishing a clear timeline of events. An invalid format would trigger an error message requiring the user to correct the entry before proceeding.
3
Logical Date Consistency
Ensures that the 'Date Signed' is not a future date and is on or after the main 'Date' listed at the top of the form. This check prevents logical impossibilities, such as signing a document before it was officially dated. If the signature date is invalid, the system will flag it as an error, as it compromises the legal validity of the declaration.
4
Worker Phone Number Format
Validates that the 'Worker Phone Number' field contains a properly formatted 10-digit phone number, potentially allowing for an extension. Correct formatting is essential for ensuring that the assigned worker can be contacted regarding the case. An improperly formatted number would result in a validation error, prompting the user to re-enter the number.
5
Customer Contact Number Requirement
This check verifies that at least one of the customer's phone numbers ('Home Telephone Number' or 'Contact/Cell Phone Number') is provided. Having a valid contact method for the customer is essential for communication regarding their case. If both fields are left empty, the form submission will be blocked until at least one number is entered.
6
Full Name Completeness
Validates that the 'Full Name (Last, First, Middle)' field contains, at a minimum, a distinct first name and last name. A full name is a fundamental requirement for legal and identification purposes. The system will reject an entry that appears incomplete, such as a single word, to ensure proper identification of the declarant.
7
ZIP Code Format Validation
Ensures the 'Zip Code' field contains a valid 5-digit or 9-digit (ZIP+4) numeric value. A correct ZIP code is critical for mail delivery and for associating the address with a specific geographic jurisdiction. An invalid entry will trigger an error, preventing address-related failures in downstream processes.
8
State Field Validation
This check confirms that the 'State' field contains a valid, recognized state name or a standard two-letter abbreviation. This is necessary for address validation and ensuring mail can be delivered correctly. An unrecognized entry would cause a validation failure, requiring the user to select from a list or correct the spelling.
9
Declaration Statement Presence
Verifies that the main 'Declaration / Statement' text area is not empty. The entire purpose of this form is to record a declaration under penalty of perjury, so a blank statement renders the form meaningless. A submission attempt with an empty declaration will be blocked with a message indicating the field is required.
10
Signature and Date Correlation
This validation ensures that if a signature is present in the 'Signature or Mark' field, the corresponding 'Date Signed' field is also filled out. A signature is legally invalid without a date. If a signature is detected without a date, the system will halt submission and require the user to enter the date the document was signed.
11
Case Number Format
Checks if the 'Case Number' conforms to the expected format for the specified county or agency (e.g., specific prefixes, length, or character types). This ensures the number is valid and can be used for automated processing, routing, and database lookups. A non-conforming case number would be flagged as a potential data entry error.
12
Required Worker Information
Ensures that the 'Worker Name' and 'Worker ID' fields are both completed. This information is vital for internal tracking, accountability, and identifying the staff member responsible for the case file. Missing worker details would prevent submission, as it creates an incomplete record for the agency.
13
County Name Presence
This check verifies that the 'County' field at the top of the form is not empty. The county is a primary piece of jurisdictional information that dictates which agency or court branch is responsible for the case. Failure to provide the county would result in a validation error, as the form cannot be correctly routed or filed without it.

Common Mistakes in Completing GEN 853

Forgetting to Sign or Date the Form

Applicants often overlook the signature and date fields at the bottom, especially when focused on the main declaration. A form submitted without a signature and date is legally invalid and will be immediately rejected, causing significant processing delays. To avoid this, always perform a final review of the entire document, paying special attention to the signature blocks, and ensure both the 'Signature or Mark' and 'Date Signed' fields are completed before submission.

Incorrectly Formatting the Full Name

The form specifically requests the name in 'Last, First, Middle' order. Many people instinctively write their name as 'First Middle Last', which can lead to data entry errors and problems with record matching in the county's system. Always read field labels carefully and enter your name exactly as requested to prevent processing issues and ensure your file is correctly identified.

Entering an Incomplete or Incorrect Case Number

The 'Case Number' is the primary identifier used to route the document to the correct file and caseworker. This mistake often happens due to a simple typo or because the applicant doesn't have the number readily available. An incorrect or missing case number will cause the form to be misfiled or returned, halting any action related to your case. Double-check the case number against official correspondence from the county before entering it.

Providing a Vague or Incomplete Declaration

The large 'Declaration / Statement' text box is the core of the form, yet it is often filled with information that is too brief, unclear, or missing essential facts. This forces the worker to request clarification, delaying the case. To avoid this, be as specific and detailed as possible, answering who, what, where, when, and why, and stick to the relevant facts of your declaration.

Leaving Worker Information Blank

Applicants may not know their 'Worker Name' or 'Worker ID' and leave these fields empty. While the form may still be processed, its absence slows down internal routing, as administrative staff must manually look up the information. If you have this information from previous communications, filling it in ensures the document gets to the right person quickly. If you don't know it, leave it blank, but be aware it may add a delay.

Incomplete Street Address

A common error is omitting the apartment, suite, or unit number from the 'Street Address' field. This oversight can lead to important mail from the county being returned as undeliverable, causing you to miss critical notices or deadlines. Always include any secondary address information to ensure reliable communication. AI-powered form fillers like Instafill.ai can help by saving your complete address and auto-filling it correctly every time.

Using Inconsistent Phone Number Formats

People enter phone numbers in various formats (e.g., (123) 456-7890, 123-456-7890, 1234567890), which can cause issues for automated systems. Furthermore, they may list a non-primary number in the 'Contact/Cell Phone Number' field. To prevent contact delays, use a standard 10-digit format and ensure the 'Contact/Cell' number is the one you answer most reliably. Tools like Instafill.ai can automatically format phone numbers consistently.

Ignoring the 'County' Field

The form is a generic state-level document (GEN 853) used by various counties, making the 'COUNTY OF' field at the top essential for routing. Applicants sometimes assume the agency already knows the county and leave it blank. This can cause the form to be sent to the wrong jurisdiction or delayed while staff determines the correct location. Always specify the county to which you are submitting the form.

Confusing the Two Signature Lines

This form includes two separate lines for 'Signature or Mark' and 'Date Signed'. An applicant might only sign one, assuming the second is for an official or a second person, which may not be the case. This can lead to the form being considered incomplete. Carefully read any instructions accompanying the form to determine if one or both signatures are required for your specific situation.

Illegible Handwriting in a Printed Form

When the form is a non-fillable PDF, it must be printed and filled out by hand. Poor or illegible handwriting, especially for critical data like names, case numbers, and addresses, is a frequent cause of rejection or data entry errors. If you must fill it out by hand, print clearly in block letters. Alternatively, services like Instafill.ai can convert flat PDFs into digitally fillable forms, eliminating handwriting issues entirely.
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