Special Assistance Notice of County of Residence Reassignment transfer 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the date at the top of the form. This should reflect the current date when you are filling out the notice.
3. Fill in your name and address in the designated fields. Ensure that all information is accurate to avoid any delays.
4. In the section addressed to you, input your name and any relevant details regarding your application for Special Assistance.
5. Specify the county where your application was approved and ensure that it matches with official records.
6. Indicate your correct county of residence, as this is crucial for maintaining eligibility for assistance.
7. Complete the effective date field, which indicates when the reassignment will take place.
8. Provide contact information for the new county's Department of Social Services, including their address and phone number.
9. Finally, sign off with your name as required at the bottom of the form before saving or exporting it.

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