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PLEASE NOTE: MUST BE 18 YEARS OR OLDER TO APPLY 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by filling out the Head of Household/Applicant Information section. Enter your first name, middle initial, last name, and Social Security number. Make sure to include your date of birth and select your sex.
- Indicate if you are disabled and select your race/ethnicity from the provided options. This information is collected for statistical purposes only.
- Complete the Household Information section with your legal address and mailing address if different. Ensure all details are accurate for effective communication.
- List all household members, starting with adults followed by children under 18. Fill in their names, Social Security numbers, dates of birth, sex, disability status, and race/ethnicity as required.
- In the Family Income and Assets section, provide total gross income for each family member aged 18 or older. Include all sources of income and specify how often they are received.
- Finally, review the Eligibility and Preferences section carefully before signing to certify that all information is true and complete.
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