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Combined application form mn

Combined application form 2026

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The document is the DHS-5223-ENG Combined Application Form for various assistance programs in Minnesota, including SNAP and cash assistance. It provides instructions on how to fill out the application, required information for eligibility, and details about the application process. The form emphasizes the importance of providing accurate information, reporting changes, and understanding rights and responsibilities related to public assistance. It also includes sections on domestic violence resources, immigration status requirements, and civil rights notices.

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Click ‘Get Form’ to open the combined application form in our platform's editor.
Begin by filling out your personal information on page 1, including your legal name, Social Security number, and address. Ensure all details are accurate for a smooth application process.
Proceed to complete the sections regarding household members. List all individuals living with you, even if they are not applying for assistance. Include their names, Social Security numbers, and relationships to you.
In the income section, provide details about your household's earnings and any other financial resources. Be prepared to submit proof of income as required.
Review the required information checklist carefully. Make sure you have included all necessary documentation such as identification and residency proof before submitting your application.
Once completed, sign and date the application on pages 1 and 10. Submit it promptly to your local agency for processing.

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Versions	Form popularity	Fillable & printable
2022	4.2 Satisfied (25 Votes)
2021	4.9 Satisfied (29 Votes)
2016	4.3 Satisfied (106 Votes)
2015	4 Satisfied (45 Votes)
2014	4.3 Satisfied (115 Votes)
2012	3.8 Satisfied (24 Votes)
2010	4.3 Satisfied (48 Votes)

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