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Get Mn Dhs-5274-eng 2018-2025
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How to use or fill out the MN DHS-5274-ENG online
The MN DHS-5274-ENG is the Minnesota Child Care Assistance Program Redetermination Form, essential for families seeking to continue receiving assistance with child care expenses. This guide provides clear, user-friendly instructions for filling out the form online to ensure compliance and timely submission.
Follow the steps to complete your Redetermination Form online.
- Press the 'Get Form' button to retrieve the MN DHS-5274-ENG and access it in the online editor.
- Begin by entering your personal information at the top of the form, including your name, phone number, address, and case number.
- In the living situation section, select the appropriate option from the list provided. If your address has changed, send proof such as a utility bill.
- List all household members under the 'Tell us who is living in your home' section. Include details like names, relationships, and birthdates.
- Document your family's income by answering the questions related to earned and unearned income. Be thorough and include all relevant earnings.
- Indicate any expenses incurred by your family in the relevant fields, such as medical, vision, or child support payments.
- Fill in the assets section, verifying if your family's assets exceed $1 million. Provide details as required.
- Answer questions regarding child care needs for any children in your household, specifying the primary and secondary child care providers.
- Under the family services section, indicate if you receive benefits like housing assistance or Supplemental Nutrition Assistance Program (SNAP) benefits.
- Review the authorization to share information for investigations and audits, checking the box to agree if you consent.
- Carefully read the penalty warning and responsibilities section, ensuring you understand the implications of providing false information.
- Sign and date the form where indicated, confirming that you have received the Notice of Privacy Practices and understand your rights.
- Finally, save your changes online, and choose to download, print, or share the completed form as needed.
Complete your MN DHS-5274-ENG online today to ensure continued assistance with your child care needs.
To gain approval for Personal Care Assistant (PCA) services in Minnesota, you will need to undergo an assessment to determine eligibility. This involves a review of your medical needs and how they impact daily living activities. For assistance and more information on the approval process, refer to MN DHS-5274-ENG for helpful guidance.
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