Get 340 Form Maryland

Filling out the 340 Form Maryland online is essential for those seeking reimbursement for interim assistance through various public assistance programs. This guide provides a step-by-step approach to ensure you accurately complete the form and streamline your application process.

Follow the steps to fill out the 340 Form Maryland online with ease.

1. Press the ‘Get Form’ button to access the form, which will open in your preferred editing tool.
2. Identify the local jurisdiction by checking the appropriate box at the top of the form and enter the relevant jurisdiction name. For Montgomery County users, check the specified box and enter the department name.
3. Choose either the 'INITIAL PAYMENT ONLY' or 'POSTELIGIBILITY PAYMENT ONLY' option by checking the corresponding box.
4. Fill in the Customer ID Number as it appears in the CARES system.
5. Enter the Assistance Unit (AU) number as indicated in CARES.
6. Select the category by writing 'TDAP', 'DEAP/TCA', or 'PAA' as applicable.
7. Provide the applicant's Social Security Number in the designated field.
8. Input the District/Territory code for your Local Department Office.
9. For the Federal Code, input the number '21', which represents Maryland.
10. Complete the County DSS Federal Code with the appropriate 3-digit code based on your local jurisdiction.
11. Enter the applicant's full name, including last, first, and middle names.
12. Fill in the applicant's street address, then their city or town, and include the zip code.
13. Provide the applicant's telephone number.
14. Have the applicant sign the ‘Signature of Recipient’ line and enter the date.
15. The Case Manager must sign on the ‘Signature of State Representative’ line and include their telephone number. Ensure the dates match the applicant's signature date.
16. Record the Grant Reimbursement Code by combining the Federal Code and County DSS Federal Code.
17. Submit the white original copy of the completed form to the Disability Entitlement Advocacy Program (DEAP) within two working days. Photocopies are not acceptable.
18. Distribute the remaining copies of the DHR/FIA 340 form: provide the goldenrod copy to the applicant, forward the yellow copy to the Local Department Finance Officer, and retain the pink copy in the case file.
19. Upon obtaining verification of medical disability, forward any relevant forms, including the 402B and 4204, along with necessary medical documentation to DEAP.

Complete your documents online today for a smooth application process.