NOTICE:

Learn about potential changes to DSS benefits due to the federal budget reconciliation bill (H.R.1) here

Fall EBT benefits have arrived. Please visit here for more information.

Economic Security - Financial Assistance

Documents/Forms

2023 FPL and SMI Percentages

Authorization for Disclosure of Information (English)

Authorization for Disclosure of Information (Spanish)

Authorization for Reimbursement of Interim Assistance (English)

Authorization for Reimbursement of Interim Assistance (Spanish)

Rights and Responsibilities (English)

Rights and Responsibilities (Spanish)

SAGA Medical Statement

SAGA Cash Medical Report

SAGA Client Supplement for Medical Information (English)

SAGA Client Supplement for Medical Information (Spanish)

SAGA Permission to Share Medical Information 

TFA Medical Report for Person Who Needs Care

TFA Medical Report for Incapacity 

TFA Noncustodial Parents Information Sheet 


For information on applying, please follow this link.

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