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WA DSHS 14-076 2015 free printable template

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YOUR NAME CLIENT ID OR SOCIAL SECURITY NUMBER Change of Circumstances Read all sections carefully. Check all boxes that apply to your household. Sign date and return this form to your local office. If you have any questions or if you need a postage paid envelope to return this form by mail contact your Your Responsibilities If your household gets cash Basic Food or medical assistance you must report changes as described under WAC 388-418-0005 182-504-0105 and 182-504-0110 based on the...
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How to fill out WA DSHS 14-076

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How to fill out WA DSHS 14-076

01
Obtain the WA DSHS 14-076 form from the official website or a local DSHS office.
02
Read the instructions carefully to understand what information is required.
03
Fill out your personal information, including name, address, and contact details in the designated sections.
04
Provide information regarding your household members and their income if applicable.
05
Indicate the purpose of the form, such as applying for services or benefits.
06
Review the filled form for accuracy to ensure all required fields are completed.
07
Sign and date the form at the bottom to certify that the information is true.
08
Submit the form either by mail or in person as instructed.

Who needs WA DSHS 14-076?

01
Individuals or families applying for assistance programs through Washington State Department of Social and Health Services (DSHS).
02
People who need to update their information for ongoing benefits.
03
Applicants seeking financial aid, food assistance, or medical benefits from DSHS.
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WA DSHS 14-076 is a form used by the Washington State Department of Social and Health Services to report information related to child support or other related services.
Individuals who are involved in child support cases, such as parents or guardians, may be required to file WA DSHS 14-076.
To fill out WA DSHS 14-076, individuals should complete the form with the required personal and financial information as instructed, ensuring accuracy and completeness.
The purpose of WA DSHS 14-076 is to gather necessary information to assist in child support enforcement and ensure compliance with child support obligations.
The information that must be reported on WA DSHS 14-076 includes personal identification details, financial information, and any relevant data concerning child support arrangements.
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