NOTICE:

Connecticut passed new legislation requiring DSS to spread out SNAP benefit issuance dates throughout the month rather than concentrating them in the first few days. Read up on the changes that start March 1.

DSS benefits have changed due to the federal budget reconciliation bill (H.R.1). Find out how it will impact you on our website, which answers questions about work requirements and exemptions for SNAP and HUSKY (Medicaid).

Applications and Forms

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  • W-300SA

    W-300SA - Medical Report For SAGA Cash Benefits - Rev.12-19

  • W-300T19

    W-300T19 - Medical Report For Title XIX Disability Determination - Rev.12-19

  • W-650

    W-650 - Authorization for Reimbursement of Interim Assistance - Rev. 09/10

  • W-650S

    W-650S - Autorización para Reembolso de Asistencia Interina - Rev. 09/10

  • W-675

    W-675 - Report Form For Protective Services For The Elderly - Rev. 06/23

  • W-682

    W-682 - DIRECT DEPOSIT AUTHORIZATION FORM - Rev. 1-23

  • W-682S

    W-682S - FORMULARIO DE AUTORIZACIÓN DE DEPÓSITO DIRECTO - Rev. 1-23

  • W-944

    W-944 - Notice of Action - Rev. 05-23

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