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Referrals Revised 2/1/16 Replaces version dated 10/1/06 245.20A Referral from the WIC Program Overview Introduction A copy of the Referral from the WIC Program form is printed on the following page.

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How to fill out revised 2116

1. Step 1: Start by obtaining a copy of the revised 2116 form.
2. Step 2: Read the instructions carefully to understand the purpose and requirements of the form.
3. Step 3: Gather all the necessary information and documents needed to fill out the form, such as personal details, financial information, and any supporting documentation.
4. Step 4: Begin filling out the form by providing accurate and complete information in each section. Follow the instructions for each field or question.
5. Step 5: Double-check all the entries before submitting the form to ensure accuracy and completeness.
6. Step 6: Make copies of the completed form and any accompanying documents for your records.
7. Step 7: Submit the filled-out form and any required attachments to the appropriate authority or organization as instructed.
8. Step 8: Keep track of the submission by noting down any reference numbers or confirmation details.
9. Step 9: Follow up on the status of your submission if necessary.
10. Step 10: Keep a copy of the filled-out form and any communications related to it for future reference.

Who needs revised 2116?

1. Individuals who are required to provide certain information or apply for specific benefits may need to fill out the revised 2116 form.
2. For example, taxpayers who need to declare certain deductions or exemptions on their tax returns may be required to fill out this form.
3. Additionally, individuals who are applying for government assistance programs or benefits may also be required to provide the necessary information using the revised 2116 form.
4. It is always advisable to refer to the specific instructions or guidelines provided by the relevant authority or organization to determine if the revised 2116 form is applicable to your situation.

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