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325 North Salisbury Street Raleigh, North Carolina 27603 Courier # 56-20-25 Michael F. Easley, Governor Carmen Hooker Odom, Secretary North Carolina Department of Health and Human Services Division
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How to fill out dss 5102:
01
Provide personal information, such as your name, address, and contact details.
02
Fill in the required fields regarding your household composition, including the names and relationship of all individuals living in your home.
03
Input information about your household income and resources, including wages, government assistance, and any other sources of income.
04
Answer questions about your current living situation, including whether you rent or own your home and if you receive any housing assistance.
05
Provide details about your medical expenses, including health insurance coverage and any out-of-pocket medical costs.
06
Indicate any child support payments or the receipt of child support.
07
Sign and date the form to certify the accuracy of the information provided.
Who needs dss 5102:
01
Individuals or families who are seeking government assistance programs, such as SNAP (Supplemental Nutrition Assistance Program) or TANF (Temporary Assistance for Needy Families), may need to fill out dss 5102.
02
Those who are applying for or receiving Medicaid benefits may also need to complete this form.
03
Some housing assistance programs, such as Section 8, may require the submission of dss 5102 as part of the application process.
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What is dss 5102?
DSS 5102 is a form used by the Department of Social Services to collect information about individuals receiving social services.
Who is required to file dss 5102?
Individuals who receive social services from the Department of Social Services are required to file dss 5102.
How to fill out dss 5102?
DSS 5102 can be filled out by providing the requested information in the appropriate fields on the form. It is important to ensure all required information is provided accurately.
What is the purpose of dss 5102?
The purpose of dss 5102 is to collect necessary information about individuals receiving social services in order to assess their eligibility and provide appropriate assistance.
What information must be reported on dss 5102?
DSS 5102 requires reporting of personal information such as name, address, contact details, income, assets, household members, and any relevant documentation related to eligibility for social services.
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