Get Pa 1827.qxp - Department Of Public Welfare - Services Dpw State Pa

Completing the PA 1827.qxp form online is essential for individuals seeking an undue hardship waiver related to long-term care services. This guide will help you navigate through the sections and fields of the form in a clear and straightforward manner.

Follow the steps to easily complete the PA 1827.qxp form online.

1. Click ‘Get Form’ button to access the form and open it in your preferred editor.
2. In the 'Personal Information' section, fill out the applicant or recipient’s last name, first name, social security number, date of birth, street address, telephone number, city, state, middle initial, and zip code.
3. Proceed to the 'Asset Transfer Information' section. Here, describe what assets were transferred. Include details on the value of the assets, the date they were transferred, and the compensation received for these assets.
4. Identify the transferee by supplying their name along with their relationship to the applicant or recipient. Additionally, provide their street address, telephone number, city, state, and zip code.
5. Explain the reason for the asset transfer. This information is crucial to the evaluation of your waiver request.
6. Moving on to the 'Additional Information' section, describe how the denial of long-term care payment would negatively impact your health or access to basic necessities such as food and shelter.
7. Detail the actions you have taken to recover your assets. Include the names and contact information of any attorneys you have consulted for assistance.
8. In the 'Signatures' section, check the agreement statement and sign the form. If applicable, also include the signature of a representative and the facility contact.
9. After completing the form, ensure you save your changes. You can choose to download, print, or share the document as needed.

Start completing the PA 1827.qxp online to secure your undue hardship waiver today.