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The Gateway Center 31 Water Street Jamestown, New York 14701 Phone: 716.487.1488 Fax: 716.665.5944 Email: office.CHH gmail.com (CHH is a 501(c)(3) notforprofit corporation. Est. March 2001) Misapplication

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Individuals who wish to apply for coverage under the DOC 8-CHH program in the year 2009 need to fill out the DOC 8-CHH Application 2009 form. This form is required for anyone seeking financial assistance or health coverage through the program. Eligibility criteria may apply, so it is advisable to read the instructions or contact the relevant authorities for further information.

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Doc 8-chh application 05 is a form used for submitting specific financial information to the regulatory authority.

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