Get Wa Dshs 14-393 2000-2026
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How to fill out the WA DSHS 14-393 online
The WA DSHS 14-393 form, known as the Statement of Shared Living Arrangement, is a crucial document that outlines how individuals at a shared address manage their living expenses. This guide will walk you through filling out the form online in a clear and supportive manner.
Follow the steps to effectively complete the WA DSHS 14-393 form.
- Press the ‘Get Form’ button to access the WA DSHS 14-393 form and open it in the online editor.
- Begin by entering your name in the 'Client's Name' field. Ensure that the spelling is accurate and matches your identification documents.
- Complete the 'Telephone Number' section by entering a valid phone number where you can be reached.
- Provide the 'Street Address' along with the 'City,' 'State,' and 'ZIP Code' to accurately identify your residential location.
- Indicate the total number of people living at your address in the corresponding field.
- For all other adults (18 and over) living at your address, fill out their name, social security number, relationship to you, and birthdate. Specify whether they share food costs and if they cook or eat meals with you.
- For children under 18 at your residence, provide each child's name, social security number, and birthdate. Clarify their relationship to the other adults living at the address.
- In the 'Expense Information' section, state your current monthly rent and indicate if there are additional costs for utilities like electrical, water, and garbage that are not included in the rent.
- Detail how you and the other adults allocate your monthly expenses by listing each person’s contributions next to the respective costs for rent, heating/cooling, electricity, water, garbage, and telephone.
- All individuals aged 18 and over must sign and date the form to affirm the accuracy of the information provided.
- Once all fields are completed, you can save changes, download, print, or share the form as necessary.
Complete the WA DSHS 14-393 form online today to manage your shared living arrangement effectively.
The Washington State Department of Social and Health Services (DSHS) provides a wide range of services including financial assistance, food programs, and child welfare. DSHS aims to enhance individuals' quality of life by connecting them with necessary resources. By leveraging programs such as WA DSHS 14-393, many residents can access crucial services that promote self-sufficiency and stability.