Follow the steps to accurately complete the form.

1. Press the ‘Get Form’ button to access the form and open it in your preferred editor.
2. Fill in Part 1 by listing the names of all household members living with you and their dates of birth.
3. If applicable, provide the SNAP/TANF number for any household member in Part 2. If none, proceed directly to the next section.
4. In Part 3, check the relevant box if any household member is homeless, a migrant, a runaway, or enrolled in Head Start. Obtain the liaison's signature and date if necessary.
5. For households without benefits, proceed to Part 4 to list income. Only complete this if you did not check any boxes in Steps 2 or 3. Record the income and how frequently it is received for each member listed.
6. In Part 5, opt in for additional benefits if applicable by checking the boxes and signing to express interest in programs such as SNAP or Health Care for All Kids.
7. Complete Part 6 by providing signature, name, address, and date of the adult household member certifying the accuracy of the provided information.
8. Optionally complete Part 7 to indicate children’s racial and ethnic identities, marking the appropriate boxes.
9. At the final step, ensure all information is accurate before saving, downloading, or printing the completed form.

Complete the Cps Family Income Information Form online to facilitate funding requests.