Get Return To: Official Use Only Initial Certification Annual Certification Income Change Household

Filling out the Return To: Official Use Only Initial Certification Annual Certification Income Change Household form is a vital step in ensuring that your information is accurately recorded for assistance programs. This guide provides clear and supportive instructions to help you complete the form online effectively.

Follow the steps to fill out the form correctly and efficiently.

1. Click ‘Get Form’ button to acquire the form and open it in your editor or document management tool.
2. Begin with the 'Personal Declaration' section. Ensure all adult members sign the form and that you type or print clearly. If a section does not apply, mark it as N/A.
3. Enter your current address, city, state, and zip code. If applicable, add your P.O. Box details.
4. Provide your phone number and email address for communication purposes.
5. List all occupants of the assisted unit. Include their legal names, relationship to the head of household, sex, age, date of birth, place of birth, social security number, and whether they are a full-time student over 18 years old.
6. For foster children, provide their names in the designated section and include documentation of their foster care status when applicable.
7. If applicable, list all students aged 18 years or older, including their names, schools attended, and whether they receive student aid.
8. Complete the working section if anyone in the household is employed. Provide their occupation, gross monthly wages, employer's details, and whether they receive overtime or bonuses.
9. If anyone is self-employed, detail their anticipated income for the next 12 months.
10. Indicate whether anyone receives additional income from any other sources outside the household. Provide an explanation.
11. Indicate if any members have expenses related to childcare for children aged 12 or under that enable work or education.
12. Provide asset information by checking 'Yes' or 'No' for each item listed regarding household resources.
13. Confidentially declare any previous arrests or issues related to drug-related activities or other criminal behavior as required.
14. Complete the certification and notice section by signing and dating as the head of the household and ensure all adults complete their required signatures.
15. Finally, review your entries for accuracy before saving changes, and proceed to download or print the completed form for your records.

Complete your forms online now to ensure your eligibility for assistance.