Applications and Forms
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Request for Exemption from the SNAP Time Limit (W1460) - English
Request for Exemption from the SNAP Time Limit (W-1460) - English - Rev. 10/24
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Request for Exemption from the SNAP Time Limit (W1460S) - Spanish
Request for Exemption from the SNAP Time Limit (W-1460S) - Spanish - Rev. 10/24
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SAGA Application for Payment of Funeral and Burial Expenses W-1053
SAGA Application for Payment of Funeral and Burial Expenses.
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SNAP ABAWD Work Requirement Medical Report W-1210
SNAP ABAWD Work Requirement Medical Report.
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Therapeutic Diet Request W-351
Therapeutic Diet Request.
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Vendor Direct Deposit Form W-260
Vendor Direct Deposit Form
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Client Rights and Responsibilities - W-0016RR Rev 1-23 - English
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Client Rights and Responsibilities - W-0016RRS Rev 1-23 - Spanish
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W-0534FH Fair Hearing Notice - Rev. 05-23
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W-0534FHS - Audiencia Imparcial - Rev. 05-23
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Request for Replacement SNAP Benefits
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Request for Replacement SNAP Benefits - Spanish
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Proof of Food Loss Form
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Proof of Food Loss Form - Spanish
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W-300MED - For Medicaid for the Employed Disabled - Rev. 12-19