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State of Illinois Department of Human Services 6(Permanent) REDETERMINATION REPORT FORM (GA-TA) Local Office Name and Address Date: Case Number: Case Name: Address: It is important for you to complete.

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How to fill out the Dhs Forms Illinois online

This guide provides a step-by-step approach to completing the Dhs Forms Illinois online. By following these instructions, you can confidently fill out the form to provide essential information for your case.

Follow the steps to complete your form accurately.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin with Section I: People who live with you. List everyone residing in your household, noting their relationship to you and their birth dates. If you need more space, attach an additional sheet of paper.
  3. Proceed to Section II: Income. Answer whether anyone in your household is currently employed or unable to work. If so, provide the necessary names and details as requested. Additionally, detail any income sources and amounts for each identified individual.
  4. In Section III: Insurance, indicate whether anyone has health or life insurance. Provide their names and the insurance companies involved. Also, report any accidents or personal injuries within your household.
  5. Move to Section IV: Assets. Answer questions regarding bank accounts, vehicles, and any other significant assets. Ensure you note the balances and ownership of these accounts as required.
  6. After completing all sections, review your responses for accuracy. Sign the form to certify that the information provided is true to your knowledge.
  7. Finally, save your changes and proceed to download, print, or share the completed form as needed.

Complete your Dhs Forms Illinois online today for efficient processing.

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Providing equitable access to social/human services, supports, programs and resources to enhance the lives of all who we serve.

The Illinois Department of Healthcare and Family Services (HFS) is responsible for providing healthcare coverage for adults and children who qualify for Medicaid, and for providing Child Support Services to help ensure that Illinois children receive financial support from both parents.

Theresa Eagleson, Director She has served in policy and administrative positions in state government since 1990, with a concentration in human services and healthcare.

Illinois Department of Human Services.

By Phone Call the DHS Help Line at 1-800-843-6154; 1-866-324-5553 TTY. Available Monday - Friday, 8:30 AM - 4:30 PM. Closed State holidays. Follow the prompts for SNAP, Cash and Medical benefits to speak to a Customer Service Agent.

You may also write the Department of Human Services (IDHS) at Department of Human Services, Bureau of Civil Affairs, 401 South Clinton St., 6th Floor, Chicago, Illinois, 60607 or call the IDHS Helpline Number at 1-800-843-6154 or 866-324-5553 TTY/Nextalk or 711 Relay.

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