Self Certification Letter Form

The U.S. Small Business Administration’s (SBA) self certification letter officially communicates a company’s size and status information to BlueCross. Additional documents must accompany claims of some statuses as directed in the form. Visit the sites provided on the Related Links page for more information. Contact our Small Business liaison officer for answers.

Self Certification Letter

  • Click the link above to download the form.
  • Completely fill out the form.
  • Include other documents as directed by the form’s instructions.
  • Submit the set of documents with your Supplier Registration Form.