Recertification papers for department of human services iowa 2010 form-2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your County Number, Worker Name, and Case Number at the top of the form. This information is crucial for identifying your case.
3. Fill out the Household Members section by listing all individuals receiving benefits with you. Include their names, Social Security Numbers, birth dates, and educational details.
4. Provide accurate income information for each household member. Attach proof of income such as pay stubs or tax records as required.
5. Complete the Expenses section if applicable, detailing any daycare costs or medical expenses not covered by insurance.
6. Sign and date page 4 of the form to certify that all information provided is correct. If someone assisted you in completing the form, include their signature as well.
7. Finally, submit your completed form along with any required documentation either by mail or in person at your local DHS office.

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