Dhs 114a 2026

1. Click ‘Get Form’ to open the DHS 114A in the editor.
2. Begin by filling in the 'Case Name', 'Case Number', and 'Date' at the top of the form. Ensure accuracy as this information is crucial for processing.
3. In the 'Deductible Report' section, list each medical expense incurred by family members. Fill in details such as 'Provider Name', 'Date of Service', and 'Amount Charged'.
4. Proceed to Section 1 where you will list yourself and all family members living with you. This ensures that all relevant individuals are accounted for.
5. Answer questions regarding income from employment or self-employment, support expenses, and other income sources. Be thorough to avoid delays.
6. Complete the assets section by detailing any assets owned by family members, including their values. This information is essential for financial assessments.
7. Finally, review your entries for accuracy, sign and date the form before submission. You can easily save or print your completed form directly from our platform.

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