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  • Al Dhr-fsd-2198 2020

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STATE OF ALABAMA FOOD ASSISTANCE SIMPLIFIED APPLICATION FOR THE ELDERLYCase Number Application Date County Do you need help filling out this application due to disability? Do you need an interpreter?.

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How to fill out the AL DHR-FSD-2198 online

The AL DHR-FSD-2198 is a simplified application form for food assistance specifically designed for elderly individuals in Alabama. This guide will help you navigate each section of the form to ensure a smooth online application process.

Follow the steps to successfully complete your application online.

  1. Press the ‘Get Form’ button to access the application and open it in your preferred online editor.
  2. In the section labeled 'Tell us who you are and where you live,' enter your full name including first, middle, and last names, along with your date of birth and Social Security number.
  3. Provide your mailing address, ensuring you include your city, county, state, and zip code. If your street address differs, enter that information separately.
  4. Fill out the telephone or message number where you can be reached during business hours.
  5. In the expedited services section, answer the questions regarding your household's cash on hand and expected income for the current month.
  6. If you wish to have an authorized representative assist you, indicate your choice and provide their name and contact information.
  7. List all individuals for whom you are applying for food assistance, ensuring all required details such as Social Security numbers and relationships are included.
  8. Continue by listing everyone living in your household that does not share meals with you.
  9. Respond to the questions regarding your household’s legal status and any felony convictions that may affect eligibility.
  10. Detail any income received by household members and describe your shelter and utility expenses.
  11. If applicable, indicate any medical expenses that you or anyone in your household pays out of pocket.
  12. Review the certification statement and provide your signature, along with the date. If applicable, a witness may sign as well.
  13. Once all fields are completed, you can save changes, download, print, or share your completed form.

Start filling out the AL DHR-FSD-2198 online today to ensure timely assistance.

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AL DHR-FSD-2198
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