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Pat Quinn, Governor Julie Amos, Director201 South Grand Avenue East Springfield, Illinois 627630002Telephone: (217) 7821200 TTY: (800) 5265812Medicaid Advisory Committee Public Education Subcommittee
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HFS Form 1409 is a form used to report income for Illinois residents who receive public assistance benefits.
Individuals who receive public assistance benefits in Illinois are required to file HFS Form 1409.
To fill out HFS Form 1409, individuals must provide information about their income sources and amounts.
The purpose of HFS Form 1409 is to ensure that individuals receiving public assistance benefits are reporting their income accurately.
Information regarding income sources and amounts must be reported on HFS Form 1409.
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