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- Click ‘Get Form’ to open the w137a form in the editor.
- 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.
- In Section I, specify the type of emergency assistance you are requesting and provide a detailed reason for your request.
- 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.
- Continue to Section III to request supportive services related to work activities. Indicate your needs clearly and provide any necessary documentation if applicable.
- 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.
- Finally, sign and date the form at the bottom before submitting it back to your worker.
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dss 7p
Please fill out this form if you need emergency assistance, additional allowances, or to add a form to your Worker. I want to add the following personRead more
W 137A Form Web fheps is a rent supplement for families with children who receive cash assistance and have been evicted or are facing eviction,