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Today s Date: / / # of Pages Attached: CITY OF DURHAM HRA CLAIM FORM Plan administered by the Layton Group EMPLOYEE INFORMATION Employer: CHECK ONE: CITY OF DURHAM Current Employee Retiree Plan Year
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How to fill out City of Durham HRA:

01
Obtain the City of Durham HRA form from the official website or the local government office.
02
Carefully read the instructions provided with the form to understand the requirements and eligibility criteria.
03
Begin filling out the form by providing your personal information such as your name, address, and contact details.
04
Proceed to answer the questions related to your household income, assets, and expenses.
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Take your time to accurately report all the necessary financial information, as any errors or omissions could affect your eligibility.
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If applicable, provide details about any healthcare coverage you currently have or have had in the past.
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Who needs City of Durham HRA:

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Residents of the City of Durham who meet certain income and asset requirements may need to fill out the City of Durham HRA form.
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Individuals or families who are in need of financial assistance for healthcare expenses could benefit from the City of Durham HRA.
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People who do not have sufficient healthcare coverage and meet the eligibility criteria may require the City of Durham HRA to access affordable healthcare services.
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Those who are uncertain about their eligibility should consult the official guidelines or reach out to the local government office for clarification.
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City of Durham HRA stands for City of Durham Housing and Rental Assistance.
Residents of the City of Durham who are seeking housing and rental assistance.
City of Durham HRA can be filled out online on the official City of Durham website or in person at the City's housing department.
The purpose of City of Durham HRA is to provide financial assistance to residents in need of housing and rental support.
Applicants are required to report their income, household size, and rental history on the City of Durham HRA form.
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