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Get Tanf Request For Benefits North Dakota Department Of Human Services Division Of Public Assistance
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How to fill out the TANF request for benefits North Dakota Department of Human Services Division of Public Assistance online
This guide will provide you with clear and comprehensive instructions on how to fill out the TANF request for benefits form online. It aims to support users in navigating each section of the document efficiently.
Follow the steps to accurately complete your TANF request for benefits form.
- Click ‘Get Form’ button to obtain the TANF request for benefits form and open it in your preferred online editor.
- Begin by entering the date you are filling out the request in the 'Date Requested' field. This ensures your application is tracked correctly.
- Input your case number in the designated section only if you have previously filed for benefits. If this is your first request, leave this field blank.
- Fill out the 'Individual Requesting TANF Benefits' section with your full name, including first name, middle initial, and last name.
- Enter your current address, ensuring the information is accurate with your city, state, and zip code.
- If your mailing address is different, complete the 'Mailing Address' field with that information.
- Provide your home telephone number and any other contact numbers, including a work or message number and a cell phone number if applicable.
- If you reside in a rural area, use the 'Directions to Home' field to provide clear information for locating your home.
- In the 'Tell Us About the People in Your Home' section, check all the relevant boxes corresponding to individuals living in your household.
- For each person checked, fill out the household members' information including their legal name, relation to you, social security number, date of birth, age, sex, last grade completed, and their status as a U.S. citizen or Latino.
- Specify the race for each household member using the codes provided for ease of identification.
- In the 'Authorization to Release Information' section, place your signature and the date to authorize the disclosure of necessary information.
- If applicable, have your guardian or legal representative sign and date the authorization.
- Once you have filled out all required fields, review your form for accuracy and completeness. You can then save changes, download the form, print it, or share it as needed.
Complete your TANF request for benefits online today to ensure you receive the support you need.
Call your human service zone eligibility worker or the Medicaid Eligibility Call Center at (844) 854-4825 or email medicaidcc@nd.gov .
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