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REVOCABLE BURIAL FUND PROVISION SUPPLEMENTAL SECURITY INCOME (SSI) RELATED CASE NAME Statement of Applicant/ Recipient or Other Person CASE NUMBER NAME OF APPLICANT/RECIPIENT NAME OF PERSON MAKING

How to fill out dshs burial fund 14

How to fill out DSHS burial fund 14:

1. Gather all necessary documents, including a death certificate, funeral home invoice, and proof of income.
2. Complete the applicant section of the DSHS burial fund 14 form, providing personal information such as name, address, and social security number.
3. Fill out the deceased person's information accurately, including their name, date of birth, and date of death.
4. Provide details about the funeral expenses, including the total cost and any amounts already paid.
5. Indicate if any other financial assistance has been received for the burial expenses.
6. Sign and date the form, certifying that all information provided is true and correct.
7. Submit the completed DSHS burial fund 14 form along with the required supporting documents to the appropriate DSHS office.

Who needs DSHS burial fund 14:

1. Individuals who have incurred funeral expenses for a deceased person.
2. Those who meet the eligibility criteria set by the Department of Social and Health Services (DSHS).
3. People who may need financial assistance to cover burial or cremation costs for a loved one.

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What is dshs burial fund 14?

The DSHS burial fund 14 is a program that provides financial assistance to help cover the cost of burying or cremating individuals who have passed away and do not have the financial means to pay for their final arrangements.

Who is required to file dshs burial fund 14?

Individuals who meet the eligibility requirements set by the Department of Social and Health Services (DSHS) are required to file for the burial fund 14.

How to fill out dshs burial fund 14?

To fill out the DSHS burial fund 14 form, individuals must provide information such as the deceased person's name, date of birth, date of death, and details about the funeral or cremation expenses.

What is the purpose of dshs burial fund 14?

The purpose of the DSHS burial fund 14 is to ensure that individuals who cannot afford to pay for their own burial or cremation expenses receive financial assistance from the state.

What information must be reported on dshs burial fund 14?

Information such as the deceased person's name, date of birth, date of death, details about the funeral or cremation expenses, and any other relevant documents must be reported on the DSHS burial fund 14.