W137a form 2026

1. Click ‘Get Form’ to open the w137a form in the editor.
2. Begin by entering the date, case name, case number, caseload, center, worker telephone number, and FH&C telephone number at the top of the form.
3. In Section I, specify the type of emergency assistance you are requesting and provide a detailed reason for your request.
4. Move to Section II and check off any additional allowances you are requesting for special needs. Fill in any required details for each allowance selected.
5. Continue to Section III to request supportive services related to work activities. Indicate your needs clearly and provide any necessary documentation if applicable.
6. In Section IV, list any individuals you wish to add to your cash assistance case. Provide their names, dates of birth, and social security numbers if known.
7. Finally, sign and date the form at the bottom before submitting it back to your worker.

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