Ldss 3421 2010 form-2026

1. Click ‘Get Form’ to open the ldss 3421 2010 form in the editor.
2. Begin with Section 1: Household Composition. Fill in your first name, middle initial, last name, and any other names you have been known by. Ensure all information is printed clearly.
3. Provide your street address, city, state, county, and phone number. Indicate how long you have lived at this address in years and months.
4. List all household members in the designated fields. Include their names, dates of birth, sex, relationship to you, social security numbers, and whether they are blind or disabled.
5. Move to Section 2: Housing. Check the appropriate box that describes your housing situation and provide details about your monthly rent or mortgage payment.
6. In Section 3: Heat and Utility Information, indicate your main source of heat and whether you pay for it directly. Complete all relevant fields regarding utility bills.
7. Proceed to Section 4: Household Income. Report gross monthly income for all household members and attach additional sheets if necessary.
8. Finally, review all sections for accuracy before signing the application on page 5. Make sure to date your signature.

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