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This form is used for reporting and documenting the resources and expenses of individuals residing in Washington state. It helps the Department of Social and Health Services (DSHS) assess eligibility for various programs and services.
This form is used for notifying the transfer or discharge of residents in adult family homes in the state of Washington.
This Form is used for declaring support payments in Washington state, specifically for Samoan speakers.
This document is used for reporting income, expenses and resources in Washington state. It is available in Amharic language for the convenience of Amharic speakers.
This form is used for reporting your resources and expenses. It is specifically for residents of Washington state who speak Chinese.
This form is used by individuals in Washington to declare support payments. It is available in Tigrinya language.
This form is used for declaring support payments in Washington state. It is available in Trukese language.
This form is used for reporting income, expenses, and resources in Washington state. It is available in Korean language.
This document is used for reporting resources and expenses in Washington for individuals who identify as Marshallese.
This form is used for pediatric care providers in Washington to document and track the care provided to infants born to mothers who are positive for Hepatitis B surface antigen (HBsAg). It serves as a checklist to ensure that proper medical interventions and follow-up measures are taken for these infants.
This type of document is used for filing a Victim Impact Statement for child victims in Texas. It is available in both English and Spanish.
This document acknowledges the receipt of information regarding a Hysterectomy procedure in South Dakota.
This form is used for obtaining consent for Medicaid sterilization procedures in South Dakota. It ensures that patients understand the risks and benefits of the procedure before it is performed.
This Form is used for reporting a job search in the state of Rhode Island.
This document is used to apply for a freshwater minnow license in Rhode Island.
This form is used for making an oral or written request for an administrative hearing in South Dakota.
This Form is used for reporting health information in South Dakota.
This document is a Provider Agreement for healthcare providers in South Dakota to participate in the Title XIX Non-emergency Medical Transportation Program.
This Form is used for declaring prior criminal convictions and military history in South Dakota.
This form is used for notifying the Estate Recovery Program in South Dakota about the death of an individual.
This Form is used for reporting welfare fraud in South Dakota. It helps gather information and evidence to investigate and address cases of fraudulent activity in welfare programs.
This Form is used for submitting a casualty referral in South Dakota.
This form is used for exiting the Supplemental Nutrition Assistance Program (SNAP) in South Dakota.
This form is used for exiting a Snap Group Home program in South Dakota.
This document is for clients in South Dakota who receive Supplemental Nutrition Assistance Program (SNAP) benefits and need to authorize debit for repayment of overissuance.
This document is an application for the South Dakota Weatherization Assistance program, which helps low-income individuals and families in South Dakota make their homes more energy-efficient.
This document is a checklist for rate filings in Texas. It contains the necessary information and requirements for submitting a rate filing.
This form is used for recording and presenting historical experience information in the state of Texas. It is likely used for various legal, business, or administrative purposes.