DSHS Form 17-211 Authorization for Ssi Facilitation Records - Washington

DSHS Form 17-211 Authorization for Ssi Facilitation Records - Washington

What Is DSHS Form 17-211?

This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DSHS Form 17-211?A: DSHS Form 17-211 is the Authorization for SSI Facilitation Records in Washington.

Q: What is the purpose of DSHS Form 17-211?A: The purpose of DSHS Form 17-211 is to give authorization for the release of SSI facilitation records in Washington.

Q: Who needs to fill out DSHS Form 17-211?A: Individuals who are seeking SSI benefits in Washington and need their facilitation records released must fill out DSHS Form 17-211.

Q: Is DSHS Form 17-211 mandatory?A: Yes, if you want your SSI facilitation records to be released, filling out DSHS Form 17-211 is mandatory in Washington.

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Form Details:

  • Released on June 1, 2012;
  • The latest edition provided by the Washington State Department of Social and Health Services;
  • Easy to use and ready to print;
  • Available in Spanish;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of DSHS Form 17-211 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.

Download DSHS Form 17-211 Authorization for Ssi Facilitation Records - Washington

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