MN DHS-3163B 2014 free printable template
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DHS3163BENG1214Referral to Support and Collections
Purpose of form
The Child Support Office will use the information you give to help collect support.
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How to fill out dhs-3163b-eng referral to support
How to fill out MN DHS-3163B
01
Begin by obtaining the MN DHS-3163B form from the Minnesota Department of Human Services website or your local office.
02
Read the instructions carefully provided at the top of the form.
03
Fill out your personal information, including your name, address, and contact details in the designated sections.
04
Provide details regarding your household members, including their names, birth dates, and relationship to you.
05
Indicate your income details, including any wages, government assistance, or other sources of income.
06
Provide the requested information regarding your expenses, such as rent, utilities, and any other relevant costs.
07
Review the form for any errors or omissions before submitting it.
08
Sign and date the form where indicated, and submit it to the appropriate agency.
Who needs MN DHS-3163B?
01
Individuals or families applying for assistance programs administered by the Minnesota Department of Human Services.
02
Residents of Minnesota seeking to determine eligibility for services such as food support, cash assistance, or health care programs.
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What is MN DHS-3163B?
MN DHS-3163B is a form used by the Minnesota Department of Human Services for reporting various information related to childcare and foster care assistance programs.
Who is required to file MN DHS-3163B?
Individuals or organizations that provide childcare services or act as foster care providers in Minnesota are required to file MN DHS-3163B.
How to fill out MN DHS-3163B?
To fill out MN DHS-3163B, you need to provide accurate information about your childcare or foster care services, including details on care type, capacity, and eligibility criteria as specified in the form instructions.
What is the purpose of MN DHS-3163B?
The purpose of MN DHS-3163B is to collect essential information for the regulation and support of childcare and foster care services to ensure compliance and quality in care provision.
What information must be reported on MN DHS-3163B?
MN DHS-3163B requires reporting information such as provider details, services provided, child demographics, and any specific requirements related to the care environment.
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