For your convenience, the complete English version of this form is attached below the Spanish version. This form is an Employment Application. The form provides that applications are considered without regard to race, color, religion, or veteran status.
Spanish Employee Application Withholding Allowance Certificate In Fairfax
Category:
State:
Multi-State
County:
Fairfax
Control #:
US-00413-SPAN
Format:
Word
Instant download
Description
Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. Se trata de una solicitud de empleo. El mismo establece que las solicitudes se consideran independientemente de la raza, el color, la religión o su condición de veterano.
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FAQ
The Department of Medical Assistance Services (DMAS) rebranded Virginia's Medicaid program as Cardinal Care.
How to Apply. If you think you could benefit from Medicaid, you can apply online at CommonHelp or contact the Enterprise Call Center at 1-833-522-5582. Language assistance is available. If you'd like more information, learn more about applying for Medicaid.
Cover Virginia also operates a statewide customer service call center for Medicaid and the FAMIS Programs at 1-855-242-8282. The call center provides general program information, application status, explanation of coverage and benefits, and assistance in resolving application issues.
If you have questions about Medicaid, please call the Department of Family Services at (703) 324-7500 to speak with representative or contact your Human Service Worker directly using the telephone number provided on your most recent notice.
Call the Enterprise Call Center at 1-833-5CALLVA. Get an application mailed to you. Call 703-324-7500. Download an application for SNAP, TANF, General Relief and more (English, Spanish).
If you have experienced a qualifying event, please notify the Benefits Division at DHRBenefitsDivision@fairfaxcounty or (703) 324-3311.
With some exceptions, a decision must be made within: 45 days of application for medical assistance. 30 days of application for SNAP benefits and financial assistance (seven days if the household qualifies for SNAP expedited services)
You can also call our office at 703-222-8234, TTY 711 or send an email to DTAPPD@fairfaxcounty.
OCT. 1, 2024, TO SEPT. 30, 2025 Household SizeNon-BBCE Net Monthly Income (100% FPL)Maximum SNAP Allotments 6 $3,497 $1,390 7 $3,945 $1,536 8 $4,394 $1,756 Each additional member $449 $2205 more rows
Overview Household SizeMaximum Allotment 1 $292 2 $536 3 $768 4 $9755 more rows