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DSHS Form 01-110A Protective Payee Periodic Social Services Report - Washington
What Is DSHS Form 01-110A?
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 01-110A?A: DSHS Form 01-110A is a Protective Payee Periodic Social Services Report form used in Washington.
Q: What is the purpose of DSHS Form 01-110A?A: The purpose of DSHS Form 01-110A is to report on the ongoing need for a protective payee for an individual receiving social services.
Q: Who is required to fill out DSHS Form 01-110A?A: The protective payee is required to fill out DSHS Form 01-110A.
Q: What information is required on DSHS Form 01-110A?A: DSHS Form 01-110A requires information about the individual receiving social services, their income, expenses, and any changes in their circumstances.
Form Details:
- Released on February 1, 1999;
- 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;
- Fill out the form in our online filing application.
Download a printable version of DSHS Form 01-110A 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 01-110A Protective Payee Periodic Social Services Report - Washington
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