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STATE OF MICHIGAN STATE OFFICE OF ADMINISTRATIVE HEARINGS AND RULES ADMINISTRATIVE HEARINGS FOR THE DEPARTMENT OF HUMAN SERVICES IN THE MATTER OF THE CLAIM OF: Reg. No.: 2010 20781 Issue No.: 4003/3008/2006
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Provide personal information: Enter your full name, address, contact information, and any other personal details required on the form. Make sure to double-check the accuracy of the information entered.
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Provide household information: Indicate the number of people living in your household, including yourself and any dependents. This may include providing their names, ages, and relationship to you.
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Provide income information: In this section, you will need to provide details about your household's income. This may include income from employment, government assistance programs, child support, alimony, or any other sources of income. Ensure that you accurately report the amounts and sources of income.
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Who needs Wayne County DHS 57:

The Wayne County DHS 57 form is typically required by individuals or families who are seeking assistance or benefits from the Wayne County Department of Health and Human Services. This form helps the department assess an applicant's eligibility for various programs and services, such as food assistance, healthcare, childcare, and other financial aid programs. Those who require assistance with income or expenses and meet the eligibility criteria for these programs may need to fill out the Wayne County DHS 57 form.
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Wayne County DHS 57 is a form used to report financial information and eligibility for public assistance programs in Wayne County, Michigan.
Individuals who are seeking or receiving public assistance benefits in Wayne County are required to file DHS 57 form.
To fill out Wayne County DHS 57, individuals must provide detailed information about their income, expenses, household composition, and other relevant financial details.
The purpose of Wayne County DHS 57 is to determine the financial eligibility of individuals for public assistance programs and to assess their need for benefits.
Information such as income, expenses, assets, household members, and other financial details must be reported on Wayne County DHS 57.
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