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Combined application form mn 2026

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The document DHS-5223-ENG is a Combined Application Form for the Supplemental Nutrition Assistance Program (SNAP), Cash Assistance, and Health Care Programs in Minnesota. It provides guidance on how to apply for these assistance programs, including eligibility requirements, necessary documentation, and instructions for completing the form. The document emphasizes the importance of providing accurate information, attending interviews, and reporting any changes in circumstances that may affect benefits. It also includes sections on rights and responsibilities of applicants, as well as resources for assistance with filling out the form.

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Click ‘Get Form’ to open the combined application form in the editor.
Begin by filling out your personal information on page 1, including your name, address, and contact details. Ensure you use black or dark blue ink if printing.
On pages 3 and 4, list all household members, even those not applying for assistance. Include their names, birth dates, and Social Security numbers where applicable.
Complete the income section by detailing all sources of income for your household. Be prepared to provide proof of this information during your interview.
Review the program options available for each household member and check the appropriate boxes for SNAP, Cash Assistance, or Health Care programs.
Sign and date the form on page 10 before submitting it through our platform to ensure your application is processed promptly.

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Versions	Form popularity	Fillable & printable
2022	4.2 Satisfied (25 Votes)
2021	4.9 Satisfied (29 Votes)
2016	4.3 Satisfied (107 Votes)
2015	4 Satisfied (45 Votes)
2014	4.3 Satisfied (115 Votes)
2012	3.8 Satisfied (24 Votes)
2010	4.3 Satisfied (48 Votes)

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What is the 6 month renewal form for food stamps in Minnesota?

The following forms may be used for the six-month renewal: l Combined Six-Month Report (DHS-5576). l Renewal for People Receiving Long-Term Care or Waiver Program Services (DHS-2128). l Household Report Form (HRF) (DHS-2120).

How much cash assistance will I get in MN?

General Assistance provides a $203 a month to individuals and $260 a month to couples if all of the following conditions apply to their circumstances: No children in the household. Little or no income.

What day does cash assistance get deposited in Minnesota?

Rapid Electronic Issuances (REI) are deposited into the clients account by 1:00 p.m. and 6:00 p.m. each working day. Monthly benefits issued via direct deposit are available the 1st of the month, or the last banking day prior to the 1st if the 1st falls on a weekend or holiday.

What is the general assistance program in Minnesota?

General Assistance (GA) helps Minnesotans with little or no income meet their basic needs. It offers a small monthly cash grant to people with serious illnesses, disabilities or other circumstances that limit their ability to work. General Assistance is interim aid to help until you find another source of income.

How do I check the status of my EBT card in MN?

EBT online portal and mobile app You will need to enter your EBT card number and PIN to access your account information. If you have questions or need help with your EBT card, call ebtEDGE customer service at 888-997-2227.

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How to apply for food stamps in Hennepin County, MN?

Apply for SNAP assistance Apply online at MNbenefits. Complete a Combined Application Form (DHS) and submit to Hennepin County. See options to submit forms below. Call 612-596-1300 Monday through Friday, 9 a.m. to 4 p.m.

Combined application form mn 2026

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What is the 6 month renewal form for food stamps in Minnesota?

How much cash assistance will I get in MN?

What day does cash assistance get deposited in Minnesota?

What is the general assistance program in Minnesota?

How do I check the status of my EBT card in MN?

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How to apply for food stamps in Hennepin County, MN?

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