Organization: | Department of Transitional Assistance |
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Date published: | March 17, 2022 |
Common Forms, Documents, and Outreach Materials.
Most forms are available online here or on DTA Connect.
Learn how to submit documents, apply for benefits, request an EBT card or letter showing the amount of benefits you receive (benefit verification letter), or complete your SNAP recertification or interim report online. If you do not find what you are looking for, call the DTA Assistance Line at (877) 382-2363.
Table of Contents
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- SNAP Benefits Applications
- SNAP Benefits Applications for Seniors
- SNAP Benefit Application (For Pure SSA Households)
- SNAP Program Brochure
- Help for Those in Need: A Resource Brochure
- Noncitizen Resource Brochure
- Your Right to Know Brochure
- What Noncitizens Need to Know Brochure
- Notice of Rights, Responsibilities and Penalties Brochure
- Multi-Lingual Form (Babel Card)
- Mail-In Agency Voter Registration Form
- SNAP-9B - Request for Replacement SNAP Benefits
- Request to Choose Someone to Be My Authorized Representative
- Permission to Share Information Form (PSI)
- SNAP Medical Expense Flyer
- Out-of-Pocket Medical Expenses Form
- SNAP Work Requirement Medical Report (FSPWR-WP-MED)
- Other Agency Certification of Shelter and Utility Costs
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- Transitional Aid to Families with Dependent Children (TAFDC) Brochure
- Direct Deposit form
- Child Support Flyer
- Noncitizen Resource Brochure
- Good Cause Medical Statement
- High School Equivalency (HSE) Test Voucher Request
- Verification of Caring for the Disabled
- Requesting TAFDC Beyond the 24-Month Limit on Benefits Brochure
- Your Guide to Using DTA Connect Brochure
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- Emergency Aid to the Elderly Disabled and Children (EAEDC) Program Brochure
- Noncitizen Resource Brochure
- Application for Funeral and Final Disposition Benefit
- Authorization for reimbursement of interim assistance Initial claim or posteligibility case
- Direct Deposit form
- EAEDC Medical Provider Statement
- Your Guide to Using DTA Connect Brochure