MD DHS/FIA 1130 2006 free printable template
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VERIFICATION OF RENT AND LIVING ARRANGEMENTS Customer Name:Client ID:Case Manager:Telephone:District/County:Date:Section I: TO BE COMPLETED BY LANDLORD OR RENTAL AGENT ONLY VOID IF ALTERED Tenant:
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How to fill out MD DHS/FIA 1130
01
Begin by obtaining the MD DHS/FIA 1130 form from the appropriate agency or their website.
02
Fill in your personal information including your name, address, and contact details in the designated sections.
03
Provide information about your household composition, including names and relationships of all members.
04
Complete the income section by detailing all sources of income for you and other household members.
05
If applicable, list any expenses that you wish to report, such as medical or childcare expenses.
06
Review the application for accuracy and completeness to avoid delays in processing.
07
Sign and date the form at the designated area to certify that the information provided is true and correct.
08
Submit the completed form to the appropriate MD DHS/FIA office, either in person or via the mail.
Who needs MD DHS/FIA 1130?
01
Individuals or families applying for assistance programs such as food assistance, energy assistance, or medical assistance may need to fill out MD DHS/FIA 1130.
02
Anyone seeking to report changes in their financial situation or household composition should also complete this form.
03
Individuals who are undergoing a recertification process for ongoing benefits will need to submit the MD DHS/FIA 1130.
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What is MD DHS/FIA 1130?
MD DHS/FIA 1130 is a form used for reporting certain financial information required by the Maryland Department of Human Services (DHS) and the Family Investment Administration (FIA).
Who is required to file MD DHS/FIA 1130?
Individuals and families applying for or receiving certain benefits from the Maryland Department of Human Services are required to file MD DHS/FIA 1130.
How to fill out MD DHS/FIA 1130?
To fill out MD DHS/FIA 1130, obtain the form from the Maryland DHS website or your local DHS office, provide the requested personal information, financial details, and any relevant supporting documents as required.
What is the purpose of MD DHS/FIA 1130?
The purpose of MD DHS/FIA 1130 is to collect necessary financial information to assess eligibility for assistance programs administered by the Maryland Department of Human Services.
What information must be reported on MD DHS/FIA 1130?
The information that must be reported on MD DHS/FIA 1130 includes personal identification information, household income, expenses, and any other relevant financial data necessary for benefit eligibility determination.
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