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California Department of Education Nutrition Services Division March 2008 Shoreline Unified School District FOR SCHOOL USE ONLY ELIGIBILITY DETERMINATION HSHLD SIZE APPLICATION FOR FREE AND REDUCED-PRICE MEALS OR FREE MILK FOR SCHOOL YEAR 2009/2010 HSHLD INCOME FREE REDUCED DENIED YEAR RND TRACK FREE with FS / CalWORKs / Kin-GAP / FDPIR TEMPORARY FREE UNTIL Direct Certified as H M R EP 45 calendar days from date of determination COMPLETE AND RETURN THIS APPLICATION TO THE SCHOOL DETERMINING...
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Who needs application hshld form?

01
Individuals or families who want to apply for government assistance programs, such as Temporary Assistance for Needy Families (TANF), Medicaid, or Supplemental Nutrition Assistance Program (SNAP).
02
Landlords or property owners who need to verify the income and household composition of their tenants.
03
Social service agencies or organizations that provide aid to individuals or families in need.

How to fill out application hshld form:

01
Begin by reading the instructions carefully. Make sure you understand the purpose of the form and the information required.
02
Provide your personal information, including your full name, date of birth, Social Security number, and contact details.
03
Fill in information about your household members. Include their names, ages, relationships to you, and their income details. If someone in your household does not have any income, make sure to indicate that.
04
Provide details about your current living situation, such as your address, whether you rent or own, and the number of bedrooms in your residence.
05
Report your sources of income. List all the money you and your household members receive, including wages, social security benefits, child support, unemployment compensation, and any other sources of income.
06
Include information about your assets, such as bank accounts, investments, or real estate properties that you own.
07
If you are applying for specific government programs, make sure to answer the relevant questions related to those programs. For example, if you are applying for Medicaid, you may need to provide information about your health insurance coverage, expenses, and medical conditions.
08
Double-check all the information you have provided to ensure accuracy and completeness. Any errors or missing information could delay the processing of your application.
09
Sign and date the application form, certifying that the information you have provided is true and accurate to the best of your knowledge.
10
Submit the completed application form to the appropriate agency or organization. Keep a copy for your records in case of any future inquiries or updates.
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Application hshld form is a form used to apply for household benefits or assistance programs.
Individuals or families who meet the eligibility requirements for household benefits or assistance programs are required to file the application hshld form.
To fill out the application hshld form, you need to provide accurate information about your household, income, expenses, and any other required details as per the instructions on the form.
The purpose of the application hshld form is to determine eligibility for household benefits or assistance programs based on the information provided by the applicant.
Information such as household size, income, expenses, assets, and any other relevant details must be reported on the application hshld form.
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