Get Dhhs-r Low Income Eligibility Bapplicationb - Whcacap

The DHHS-R Low Income Eligibility Application is a crucial form for individuals seeking low-income transportation services. This guide provides clear, step-by-step instructions to assist users in completing the application form accurately and efficiently online.

Follow the steps to successfully complete the application online.

1. Press the ‘Get Form’ button to access the DHHS-R Low Income Eligibility Application form and open it in your preferred editor.
2. Begin by filling in the name of the client and their phone number. Make sure to provide accurate contact information.
3. Enter the complete address of the client, ensuring all details, including the city and zip code, are correct.
4. Indicate the eligibility category by checking the appropriate box corresponding to your status, such as elderly individuals or people with disabilities.
5. Provide the gross monthly earnings for all household members. Clearly list the income for each person, including benefits like SSI, SSDI, TANF, and others.
6. Attach verification documents for earned and unearned income, as specified in the form, ensuring that all required documentation is included.
7. Indicate any transportation needs by checking the appropriate boxes for rides or reimbursement.
8. Have the client or an authorized representative sign and date the application, along with listing their relationship to the client.
9. List the name, relation, date of birth, and signature for each member of the household, making sure to include any individual over 18 years of age.
10. Review the completed application to ensure all information is accurate and that all required signatures are provided.
11. Once completed, save the application changes, and choose the option to download, print, or share the form as necessary.

Complete your DHHS-R Low Income Eligibility Application online today to ensure timely processing of your transportation services.