MN DHS-3360-ENG 2022-2025 free printable template
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DHS-3360-ENG 9-22
Electronic Funds Transfer for DSP, FIP, GA,
MSA or RCA benefits
Safe, reliable, smart, easy
Your Diversionary Work Program (DSP),
Minnesota Family Investment Program (FIP),
General
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How to fill out MN DHS-3360-ENG
01
Obtain the MN DHS-3360-ENG form from the Minnesota Department of Human Services website or your local office.
02
Begin by filling out the applicant's personal information, including name, address, and contact details.
03
Provide information about your household members, including their relationship to you and their employment status.
04
List any income sources for all household members, including wages, self-employment, and benefits.
05
Document your expenses, including housing costs, utilities, childcare, and other relevant monthly expenses.
06
Review the instructions on the page to ensure all necessary sections are completed accurately.
07
Sign and date the form, affirming that the information provided is true and complete.
08
Submit the completed form through the appropriate channels: by mail, fax, or in-person to your local DHS office.
Who needs MN DHS-3360-ENG?
01
Individuals or families seeking financial assistance programs in Minnesota, including General Assistance, Minnesota Family Investment Program (MFIP), or related benefits, need to fill out the MN DHS-3360-ENG form.
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What is MN DHS-3360-ENG?
MN DHS-3360-ENG is a form used by the Minnesota Department of Human Services for reporting certain required information related to public assistance programs.
Who is required to file MN DHS-3360-ENG?
Individuals applying for or receiving public assistance benefits in Minnesota are required to file the MN DHS-3360-ENG form.
How to fill out MN DHS-3360-ENG?
To fill out MN DHS-3360-ENG, provide accurate information as instructed on the form, ensuring all sections are properly completed, and submit it to the appropriate agency.
What is the purpose of MN DHS-3360-ENG?
The purpose of MN DHS-3360-ENG is to collect necessary information from applicants or recipients to determine eligibility and calculate benefits for public assistance programs.
What information must be reported on MN DHS-3360-ENG?
The form requires reporting of personal information, household composition, income details, and any other relevant information as specified in the instructions.
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