WA DSHS 14-078 2014 free printable template
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DSHS 14-078 X REV. 09/2014 Page 1 Citizenship and Identity for Washington Apple Health U.S. citizens must prove citizenship and identity to receive Washington Apple Health. See www. dshs. wa.gov for locations. Fax your review to 1-888-338-7410. Mail your review to one of the following DSHS CSD-Customer Service Center PO Box 11699 Tacoma WA 98411-6699 Home and Community Services Long Term Care Services PO Box 45826 Olympia WA 98504-5826 You can also fill out this review online at www....
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How to fill out WA DSHS 14-078
01
Begin by downloading the WA DSHS 14-078 form from the Washington State Department of Social and Health Services website.
02
Fill in your personal information at the top of the form, including your name, address, and contact details.
03
Indicate the type of assistance you are applying for by checking the appropriate box.
04
Provide details about your household members, including their names, relationships to you, and ages.
05
Fill in your income information, including sources and amounts for all household members.
06
Complete any additional sections that are relevant to your application, such as expenses or special circumstances.
07
Review the form for accuracy and completeness before signing and dating it.
08
Submit the completed form as instructed, either by mail or electronically.
Who needs WA DSHS 14-078?
01
Individuals or families seeking assistance from the Washington State Department of Social and Health Services (DSHS) for programs such as food assistance, cash assistance, or other welfare benefits.
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What is WA DSHS 14-078?
WA DSHS 14-078 is a form used by the Washington State Department of Social and Health Services for reporting purposes, typically related to specific programs or services.
Who is required to file WA DSHS 14-078?
Individuals or organizations that participate in certain programs administered by the Washington State DSHS, as identified in program guidelines, are required to file WA DSHS 14-078.
How to fill out WA DSHS 14-078?
To fill out WA DSHS 14-078, obtain the form from the DSHS website or a local office, complete the requested information accurately, and submit it according to the provided instructions.
What is the purpose of WA DSHS 14-078?
The purpose of WA DSHS 14-078 is to collect essential data and information required for assessing eligibility, compliance, or service delivery within various DSHS programs.
What information must be reported on WA DSHS 14-078?
The information reported on WA DSHS 14-078 may include personal identifiers, program participation details, income information, and other relevant data as specified in the instructions.
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