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This document is made available electronically by the Minnesota Legislative Reference Library as part of an ongoing digital archiving project. http://www.leg.state.mn.us/lrl/lrl.asp DHS4189FENGReview

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DHS-4189F-ENG is needed by individuals who are seeking government assistance or benefits, such as refugee services, cash assistance, medical assistance, or food support. It is specifically required by the United States Department of Homeland Security (DHS) to assess an individual's eligibility for these programs. Anyone who is eligible and wishes to apply for these services would need to fill out this form.

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dhs-4189f-eng is a form required by the Department of Homeland Security for certain immigration-related purposes.

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