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- Begin by filling out your personal information in Section 1. Ensure you provide your full name, current address, and contact details accurately.
- In Section 2, if applicable, provide details about your spouse, including their name and birthdate. If they are deceased, indicate the date of death.
- Complete Section 3 regarding dependents. List any dependent children along with their names, dates of birth, and gross income.
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- Continue through Sections 6 to 10 by providing necessary financial information and verifying all assets as required.
- Finally, review all sections for accuracy before signing the application at the end of the form.
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DSS-EA-240 01-2026. 1. Application for Resource. Assessment, Long-Term Copy of Notices from DSS-EA Relating to Application/Renewal Form Dated: Month(s).Read more