Form PA-77 Intent to Apply for Ktap, Medicaid, State Supplementation, and / or Child Care Assistance - Kentucky

Form PA-77 Intent to Apply for Ktap, Medicaid, State Supplementation, and / or Child Care Assistance - Kentucky

What Is Form PA-77?

This is a legal form that was released by the Kentucky Department for Community Based Services - a government authority operating within Kentucky. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form PA-77?A: Form PA-77 is an Intent to Apply for KTAP, Medicaid, State Supplementation, and/or Child Care Assistance in Kentucky.

Q: What is KTAP?A: KTAP stands for Kentucky Transitional Assistance Program, which provides temporary cash assistance to low-income families.

Q: What is Medicaid?A: Medicaid is a government health insurance program that provides coverage to low-income individuals and families.

Q: What is State Supplementation?A: State Supplementation is a program that provides additional cash assistance to certain individuals who receive Supplemental Security Income (SSI).

Q: What is Child Care Assistance?A: Child Care Assistance is a program that helps low-income families pay for child care services while they work, attend school, or participate in job training.

Q: Who should submit Form PA-77?A: Individuals who wish to apply for KTAP, Medicaid, State Supplementation, and/or Child Care Assistance in Kentucky should submit Form PA-77.

Q: What information is required on Form PA-77?A: Form PA-77 requires information about the applicant's income, household members, assets, and other relevant details.

Q: Is there a deadline for submitting Form PA-77?A: There may be a deadline for submitting Form PA-77, so it's important to check with the Kentucky Cabinet for Health and Family Services.

Q: Can I apply for multiple assistance programs with Form PA-77?A: Yes, Form PA-77 allows you to indicate your intent to apply for multiple programs, such as KTAP, Medicaid, State Supplementation, and Child Care Assistance.

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Form Details:

  • Released on October 1, 2017;
  • The latest edition provided by the Kentucky Department for Community Based 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 Form PA-77 by clicking the link below{class="scroll_to"} or browse more documents and templates provided by the Kentucky Department for Community Based Services.

Download Form PA-77 Intent to Apply for Ktap, Medicaid, State Supplementation, and / or Child Care Assistance - Kentucky

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