Get 04-174 Date 06-21-2004 To: From: County Welfare Director Supply Clerk / Forms Coordinator Forms

This guide provides detailed instructions on how to accurately complete the 04-174 form, which notifies changes regarding food stamp benefits. Following these steps will ensure proper filing and processing of your form online.

Follow the steps to successfully fill out the 04-174 form online.

1. Click the ‘Get Form’ button to obtain the form and open it in the designated editor.
2. Begin by entering the date on the first line of the form. This date should reflect when you are completing the form.
3. Complete the 'To:' field by entering the name and title of the County Welfare Director.
4. Fill in the 'From:' field with your title as either the Supply Clerk or Forms Coordinator, followed by the name of your department.
5. Identify the specific form being referenced, which is clearly stated at the top of the document under 'FORM NUMBER AND TITLE.' Make sure you have the correct form version.
6. If applicable, note the initial supply sent and whether the form is sold or free, as indicated in the designated section.
7. In the 'CHANGE IN BENEFITS' section, document any alterations to the food stamp benefits, including amounts and reasons for the changes.
8. If there are no changes in benefits, provide the details in the 'NO CHANGE IN BENEFITS' section, ensuring that the reasons are clearly articulated.
9. Include any comments or notes relevant to the action in the 'COMMENTS' section.
10. Sign and date the bottom of the form, ensuring that the name of the person completing the form is legibly printed.
11. Upon completion, save any changes made to the form. You can then download, print, or share the finalized form as needed.

Take action today to complete your documents online and ensure timely processing.