Dfa form 768 2025

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The document is a form from the New Hampshire Department of Health and Human Services, specifically the Division of Family Assistance. It is designed for clients to report shared shelter arrangements and meal arrangements for food stamps. The form collects personal information about the client, details about household members, their relationship to the client, and their food purchasing habits. Additionally, it inquires about rent responsibilities and utility costs associated with the shelter arrangement.

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Click ‘Get Form’ to open the DFA Form 768 in the editor.
Begin by entering your personal information in the 'Client' section, including your name, physical address, mailing address, case number, and telephone number.
In the 'Meal Arrangement for Food Stamps' section, list everyone who lives with you. Fill in their names, relationship to you, and telephone numbers. Indicate if their name is on the shelter’s lease and whether they buy their own food.
For the 'Shelter Arrangement' section, answer whether your name is on the lease. If yes, complete DFA Form 775 or provide a copy of the lease if not on file. Specify your portion of rent and indicate responsibilities for heating, telephone, electricity costs, and internet service.
Finally, sign and date the form at the bottom before submitting it to the Centralized Scanning Unit (CSU).

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Versions	Form popularity	Fillable & printable
2017	4.8 Satisfied (53 Votes)
2015	4 Satisfied (41 Votes)

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