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Get Wa Dshs 14-252(x) 2015-2026
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How to fill out the WA DSHS 14-252(X) online
Filling out the WA DSHS 14-252(X) form online is a straightforward process. This guide will help you navigate each section of the form clearly and effectively, ensuring you provide all necessary information correctly.
Follow the steps to successfully complete the form.
- Press the ‘Get Form’ button to obtain the form and open it in the online editor.
- Fill out the client/employee section. Start with the authorization statement, allowing the employer to release information to the Department of Social and Health Services. Sign where indicated, and provide your social security number if you choose.
- Move to the employer section. Enter the employee's name, employer's name, job title, and employer's address. Also, fill in the date the employee started working.
- Indicate whether this is a new job and how many average hours the employee works per week. Specify the pay frequency, and provide the rate of pay or salary, noting if it is on a daily, hourly, or piece-rate basis.
- Indicate if this job is a Work Study position, and if applicable, provide the date the first check was received.
- State whether the job has ended and, if so, the termination date along with an explanation.
- Report actual gross income for the last three months, as well as for the current month and projected gross income for the next two months. Ensure the data is accurately documented.
- Detail any tips, commissions, bonuses, or overtime received by the employee, underscoring frequency and amounts if applicable.
- Complete the work schedule, noting the exact times for each day when possible.
- Finally, address health insurance availability. Indicate if the employee is enrolled in a health plan and provide the details on premium costs. Obtain the employer/representative's signature and their printed name and title, along with the phone number.
- Once you have completed all sections, review the form for any errors, then save your changes, download, print, or share the completed form as needed.
Complete your document online today to ensure timely processing.
Related links form
The maximum income to qualify for food stamps in Washington mainly depends on the number of people in your household. Generally, your household income must fall below 130% of the Federal Poverty Level. It is important to check the current income eligibility guidelines on the DSHS website. For specific calculations and resources, refer to WA DSHS 14-252(X).