DHS-1171 Information Booklet and Applicaton DHS-1171 Information Booklet and Applicaton - coveragefo-2025

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  1. Click ‘Get Form’ to open the DHS-1171 Information Booklet and Application in our editor.
  2. Begin by reading the entire booklet carefully. It contains essential information about the assistance programs available.
  3. Fill out the application form by providing accurate answers to all questions. Ensure you include your name, date of birth, address, and signature.
  4. For each household member, provide their details including relationship to you, social security number, and any relevant medical information.
  5. If applicable, indicate any income sources or assets your household has. This includes employment income, benefits received, and other financial resources.
  6. Once completed, save your document. You can then print it or submit it electronically through our platform for free.

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MI DHS-4574 is a form used by the Michigan Department of Health and Human Services (MDHHS) to collect information regarding an individuals eligibility and circumstances related to public assistance programs.
If you have questions or need help completing your application, we recommend contacting a MI Bridges Navigator near you.
If you experience any problems with the MI Bridges online assistance application: Call the MI Bridges Help Desk at 844-799-9876. If you need help with using MI Bridges online, MI Bridges Navigators are available for one-on-one assistance. Go to Help on the website and search for community partners.
What Is DHS-431 Self-Employment Statement Form. The DHS-431 Self-Employment Income and Expense Statement is Michigans official form for reporting self-employment earnings to qualify for essential state benefits including SNAP (food assistance), TANF (cash assistance), Medicaid, and childcare programs.
How long does it take to process an application? ProgramStandard of Promptness Expedited Food Assistance (FAP) 7 Days Non-expedited Food Assistance (FAP) 30 Days Medicaid (MA) 45 Days Medicaid for pregnant women 15 Days6 more rows
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Managing My Case I am currently receiving benefits, but I dont see my benefits information in MI Bridges. What can I do? If you are unable to see your benefits, you can call the Help Desk at 1-844-799-9876.

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