DHS-3043 - Earned Income Tax Credit Temporary Assistance for Needy Families (TANF). Earned Income Tax Credit TANF-2026

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The document outlines the eligibility determination process for the Temporary Assistance for Needy Families (TANF) program by the Michigan Department of Health and Human Services. It includes sections for applicants to provide personal information, family size, income details, and existing assistance programs. The eligibility criteria are specified, indicating that families with children or pregnant individuals may qualify based on their responses. The document also emphasizes non-discrimination and equal opportunity in service provision.

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Click ‘Get Form’ to open it in the editor.
Begin by filling out your personal information in Section A, including your name, date of service, and case number if applicable.
Answer Question 1 regarding your family situation. Indicate if you are pregnant or have a child under 18 living with you.
In Question 2, check all programs your family currently receives, such as Medicaid or Food Assistance. If none apply, proceed to Question 3.
For Question 3, circle your family size and indicate whether your monthly income is less than the specified amounts based on your family size.
Review the information for accuracy and complete Section B by signing and dating the form.
Finally, submit the form for eligibility determination by a contractor or MDHHS specialist in Section C.

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DHS-3043 - Earned Income Tax Credit Temporary Assistance for Needy Families (TANF). Earned Income Tax Credit TANF-2026

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