DSHS Form 17-211 Authorization for Ssi Facilitation Records - Washington (Lao)

DSHS Form 17-211 Authorization for Ssi Facilitation Records - Washington (Lao)

This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington.

The document is provided in Lao. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the DSHS Form 17-211?A: The DSHS Form 17-211 is a form used in Washington State for authorizing access to SSI facilitation records.

Q: What is SSI?A: SSI stands for Supplemental Security Income, a federal program that provides financial assistance to individuals with limited income and resources.

Q: What are SSI facilitation records?A: SSI facilitation records refer to the documents related to the facilitation services provided by the state for SSI applicants.

Q: Who needs to fill out the DSHS Form 17-211?A: The DSHS Form 17-211 needs to be filled out by individuals who want to authorize access to their SSI facilitation records in Washington State.

Q: What is the purpose of the DSHS Form 17-211?A: The purpose of the DSHS Form 17-211 is to grant permission for the release of SSI facilitation records to authorized individuals or organizations.

Q: Can the DSHS Form 17-211 be completed in languages other than English?A: Yes, the DSHS Form 17-211 is available in multiple languages, including Lao.

Q: Is there a fee for submitting the DSHS Form 17-211?A: No, there is no fee for submitting the DSHS Form 17-211.

Q: What should I do if I need help filling out the DSHS Form 17-211?A: If you need help filling out the DSHS Form 17-211, you can contact the Washington State Department of Social and Health Services for assistance.

ADVERTISEMENT

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;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

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 (Lao)

4.5 of 5 (76 votes)
  • DSHS Form 17-211 Authorization for Ssi Facilitation Records - Washington (Lao), Page 1
ADVERTISEMENT

Related Documents