This is the form on which people apply for multiple assistance programs including cash assistance, SNAP, and emergency programs.

ocial Security, Veteran benefits, Unemployment insurance, workers’ compensation, retirement benefits, child or spousal support are all examples of this type of income.

Rent, mortgage, association fees, homeowner’s insurance are examples of this type of expense.

Less than $150 gross monthly income and $100 or less in liquid assets OR combined gross monthly income and liquid assets are less than shelter expenses.

APPL, MEMB, MEMI, ADDR.

For some programs, assistance units which receive earned income are required to report monthly on this form.

Salaries and wage income are two examples of this type of income.

Heating/Air conditioning, electric and phone are examples of this type of expense.

Birth certificate, Religious Record, Driver’s License/State Id, Divorce Decree, or Permanent Resident card.

This date is very important because it establishes when eligibility may begin.

This form can be used to verify rent and utility costs.

Product sales, Personal services, in-home day care, property rental and taxi drivers are examples of this type of income.

The single utility standard, the electric standard and the phone standard.

This SNAP requirement can be completed in-person or by telephone.

This code indicates that the client has provided his or her SSN. If the client has written their SSN on the application, you are not required to obtain a copy of the card.

This form can be used to report income and expenses for people when they work for themselves.

Grants and loans for student which are authorized by the Federal Higher Education Act (Title IV), and are funded by the U.S. Dept. of Education.

The costs for the care of a child because the applicant is working or looking for work.

Everyone in the household that buys, fixes or eats food together.

These can be updated by the worker who created them on the day they are created. After that, they are saved permanently, as is, and cannot be updated.

These required forms are used to request verifications.

Payment for a service in a form other than money, or receipt of non-cash contributions such as gift cards, food, or clothing.

These can be used as an expense in the SNAP budget if the person who incurred the costs is disabled or aged.

County agencies need to provide interpreters for this type of applicant.

The reference number assigned to a spouse.