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How to use or fill out DHS-5576-ENG (Combined Six-Month Report)
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Click ‘Get Form’ to open it in the editor.
Begin by filling in your personal information in Section 1, including your name, address, date of birth, and phone number. Ensure all details are accurate.
In Section 2, indicate if anyone has moved in or out of your home in the past six months. If yes, provide their details as requested.
Proceed to Section 3 to report on health care coverage. Answer whether anyone is receiving benefits through Medical Assistance or Medicare Savings Program.
Continue through Sections 4 to 12, providing information about employment status, income sources, assets, and any changes since your last application.
Finally, review all sections for completeness and accuracy. Sign and date the form before submitting it back to your county agency.
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Fill out DHS-5576-ENG (Combined Six-Month Report). This form is sent to clients who have a six-month renewal for health care eligibility or a six-month report for the Supplemental Nutrition Assistance Program (SNAP) due. When used, this form also meets any mo online It's free
Understanding SNAP recertification This is automatic; you dont have to do anything. Approximately one month before your certification period ends, however, your state agency will send you an official Notice of Expiration.
How to fill out SNAP recertification?
How to fill out the SNAP Recertification Form Instructions? Answer all questions on the recertification form. Sign and date the form. Attach all required documentation. Submit the form to the DHS office via mail, fax, or in person. Complete the scheduled interview.
Is SNAP automatically renewed?
A Food Stamp redetermination is a reapplication for benefits. Under no circumstances are benefits continued past the month of redetermination, unless a redetermination is completed and the client is found eligible.
What is the 6 month renewal form for food stamps in Minnesota?
RECERTIFICATION PROCESS ●Combined Six-Month Report (DHS-5576) (PDF). ● Combined Annual Renewal for Certain Populations (DHS-3727) (PDF). ● Household Update Form (DHS-8107) ● Other notices or forms required at recertification ing to each programs provisions below.1 more row Sep 3, 2024
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Sep 2, 2025 Six-Month Reporters are required to complete a Combined Six-Month Report (CSR) (DHS-5576) (PDF). This is due by the 8th of the month of the
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