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Dhhs form 3400 b-2026
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- Click ‘Get Form’ to open the dhhs form 3400 b in the editor.
- Begin by entering the name and Social Security Number of the person needing assistance in Section 1. Ensure accuracy as this information is crucial for eligibility determination.
- In Section 2, indicate the current location of the individual—whether at home, a hospital, or a nursing home. If they are not at home, provide details about their current facility.
- Proceed to Section 3 and check if anyone holds Conservatorship, Guardianship, or Power of Attorney for the applicant. If applicable, attach legal documentation.
- Sections 4 through 6 require you to answer questions regarding income allocation and previous employment benefits. Be thorough in your responses to ensure all relevant information is captured.
- Continue filling out Sections 7 through 10 by providing details about any additional income sources and assets owned by the applicant or spouse. Attach necessary proof as indicated.
- Finally, review all sections for completeness and accuracy before signing at the end of the form. Use our platform’s features to save your progress and make edits as needed.
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