You may fill out the voter registration application form in private. If you believe that someone has interfered with your right to register to vote decline to register to vote privacy in deciding whether to register or in applying to register to vote or choose your own political party or other political preference you may file a complaint with Michigan Secretary of State PO Box 20126 Lansing MI 48901-0726. Case Name Case Number Date APPLICATION FOR STATE EMERGENCY RELIEF MDHHS Office / Specialist / ID Michigan Department of Health and Human Services Phone Fax Individual ID I hereby make application for the State Emergency Relief SER Program. I understand that the following information will be used in the determination of my eligibility for SER. I also understand that there may be a delay in processing if there is missing information. If this application is for burial services I understand that it must be received by the MDHHS office in my area no later than 10 business days after the b....
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How to fill out the MI DHS-1514 online
Completing the MI DHS-1514 form for the State Emergency Relief Program is an important process for those in need of assistance. This guide will walk you through each section of the form, providing clear instructions to ensure you have the necessary information prepared for submission.
Follow the steps to complete the MI DHS-1514 online
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by entering your personal information, such as your name, case name, and case number in the designated fields. Ensure accuracy as this information is crucial for processing your application.
- Fill out the household information section. List all individuals living in your home. This includes providing names, birth dates, citizenship status, and relationships for each member, including temporary absences.
- Indicate your household address and, if applicable, the mailing address if different. This ensures that all correspondence and notifications are sent to the correct location.
- Provide your contact information, including phone number, email address, and a contact name for leaving messages. This information is critical should the MDHHS need to reach you for any follow-up.
- Answer the questions regarding drug-related felonies, probation or parole violations, and any fleeing from prosecution. Being transparent ensures a smoother application process.
- Detail your heating sources and any issues with your heating, electricity, or fuel services. Include dates if applicable to support your application for emergency assistance.
- If you are applying for burial services, complete the relevant section, detailing the deceased’s information and associated costs. Attach any required proof, such as funeral home details.
- List all sources of your household's income and expenses over the past six months in the provided sections, ensuring to attach any proof of income or benefits received.
- Review your completed form carefully for accuracy and completeness. Missing information can delay processing.
- Once satisfied with your entries, you can save changes, download, print, or share the form as needed for submission.
Complete your MI DHS-1514 form online today to get the assistance you need.
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DHS-1514 (Rev. 9-18) Previous edition obsolete. 1. APPLICATION FOR STATE. EMERGENCY...
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