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STATE OF CONNECTICUT DEPARTMENT OF SOCIAL SERVICES OFFICE OF LEGAL COUNSEL, REGULATIONS, AND ADMINISTRATIVE HEARINGS 55 FARMINGTON AVENUE HARTFORD CT 06105 2022 Signature confirmation Case: Client:

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snap2022190083pdf - ctgov is needed by individuals who are applying for or requesting information related to benefits under the Supplemental Nutrition Assistance Program (SNAP), also known as food stamps.

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This form may be required for new applications, recertification, changes in circumstances, or any other SNAP-related processes.

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Eligible individuals who need assistance with affording nutritionally adequate food may need to fill out this form and submit it to the appropriate authorities.

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