Get Rap Application Cuyahoga County Form
ERSONAL SPENDING ALLOWANCE (PSA) OF $100? CIRCLE, YES OR NO (CIRCLE NO IF CLIENT IS RECEIVING SS BENEFITS.) IF YES, MAKE CHECK PAYABLE TO: Name: Address: City, State, Zip: REMINDERS SSA Consent for Release of Information on page 4 must be completed whether receiving benefits or not. Application will not be processed until all required documentation is submitted. Client cannot be moved to the ACF until there is a signed Approval Notification from the ADAMHS Board. RE.
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