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Get Il Dhs Form Il444-2378b 2021-2025
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How to fill out the IL DHS Form IL444-2378B online
This guide provides clear instructions for completing the IL DHS Form IL444-2378B online. By following the steps outlined below, users can efficiently fill out the form for cash and medical assistance.
Follow the steps to successfully complete the form online.
- Click ‘Get Form’ button to obtain the form and open it in your editor.
- Start by entering your last name, first name, middle initial, and maiden name as needed in the designated fields.
- Fill in your present address, including the apartment number, city, state, zip code, and county.
- Provide your birth date and social security number in the designated fields.
- Complete the mailing address section if it differs from your present address, including the same city, state, and zip code.
- Indicate your telephone numbers for both home and work, and provide the best time to reach you.
- Respond to the question about homelessness by selecting 'Yes' or 'No'.
- If you wish to name an approved representative, complete that section with their name, address, and phone number.
- Sign Page 18 to confirm the application, noting that this signature will start the application process.
- Review all entered information for accuracy before saving, downloading, or printing the form.
Complete your applications online today and take a step towards securing your benefits.
Illinois Medicaid? Household Size*Maximum Income Level (Per Year)1$20,1212$27,2143$34,3074$41,4004 more rows
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